Clear Water Medical LLC
NPI #1043512783 in Wilmington, North Carolina
Provider Information
- NPI Number
- 1043512783
- Entity Type
- Organization
- Organization Name
- Clear Water Medical LLC
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Dec 1, 2010
- Last Updated
- Dec 1, 2010
Practice Location
- Address
- 4912 LAKE RENAISSANCE CIR
- City
- Wilmington
- State
- North Carolina
- ZIP Code
- 28409-3303
- Phone
- (910) 465-2783
Authorized Official
- Name
- WILLIAM ANTHONY GORE, PA
- Title
- MANAGING MEMBER
- Phone
- (910) 465-2783
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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