OrganizationActive
Coastal Carolina Internal Medicine, PA
NPI 1881619740 · Primary Care Clinic/Center · Jacksonville, NC
Provider details
- NPI number
- 1881619740
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mitzi Ros, Office Manager(910) 937-0008
- License
- 200200443 (NC)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2420 Henderson Dr
Jacksonville, NC 28546-5254
Phone: (910) 937-0008
Fax: (910) 937-0098
Approximate (ZIP-level) locationGet directions
Mailing address
2420 Henderson Dr
Jacksonville, NC 28546-5254
Registry dates
- Enumerated
- 2006-07-13
- Last updated
- 2019-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.