OrganizationActive
Extended Care Physicians - Coastal, PA
NPI 1114191525 · Geriatric Medicine (Family Medicine) Physician · Wilmington, NC
Provider details
- NPI number
- 1114191525
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Robin Gleeson-Warren, Director of Credentialing(828) 210-2678
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Geriatric Psychiatry Physician2084P0805X
Allopathic & Osteopathic Physicians
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1013 Porters Neck Rd
Suite 130
Wilmington, NC 28411-8130
Phone: (910) 795-1471
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 890194
Charlotte, NC 28289-0194
Registry dates
- Enumerated
- 2008-04-16
- Last updated
- 2014-03-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.