Organization Name: | ACT MEDICAL GROUP PA |
NPI Number: | 1245219799 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ERINN M BEEKMAN (PRESIDENT) |
Mailing Address: | 311-4e Judges Rd Wilmington |
State: | NC US |
Postal Code: | 284053655 |
Phone Number: | 9107916767 |
Fax Number: | 9107916890 |
NPI Enumeration Date: | 01/12/2006 |
NPI Last Update Date: | 12/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |