Provider Demographics
NPI:1134144173
Name:LIGUORI, JOHN CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CARL
Last Name:LIGUORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2800 ASHTON DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2486
Mailing Address - Country:US
Mailing Address - Phone:910-794-8892
Mailing Address - Fax:910-794-8895
Practice Address - Street 1:2800 ASHTON DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2486
Practice Address - Country:US
Practice Address - Phone:910-794-8892
Practice Address - Fax:910-794-8895
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC00394422081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951935Medicaid
NC8951935Medicaid
NC2153094BMedicare ID - Type Unspecified