| Organization Name: | MEDAC HEALTH SERVICES PA |
| NPI Number: | 1356345920 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL P. MOULTON, M.D. (PRESIDENT) |
| Mailing Address: | 4402 Shipyard Blvd Wilmington |
| State: | NC US |
| Postal Code: | 284036161 |
| Phone Number: | 9104521400 |
| Fax Number: | 9103321072 |
| NPI Enumeration Date: | 06/10/2005 |
| NPI Last Update Date: | 01/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15811 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |