| NPI | 1720458326 |
|---|---|
| Doing Business As | SEASIDE WELLNESS OF SHALLOTTE |
| Entity Type | Organization |
| Authorized Contact | DAVID K. MOYE Executive Director 919-233-5956 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2016-04-01 |