Provider Demographics
NPI:1235217258
Name:DUPLIN MEDICAL ASSOCIATION
Entity Type:Organization
Organization Name:DUPLIN MEDICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-293-3401
Mailing Address - Street 1:107 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-1933
Mailing Address - Country:US
Mailing Address - Phone:910-293-3401
Mailing Address - Fax:910-293-4530
Practice Address - Street 1:107 N CENTER ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NC
Practice Address - Zip Code:28398-1933
Practice Address - Country:US
Practice Address - Phone:910-293-3401
Practice Address - Fax:910-293-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101600363AM0700X
NC103247363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901465Medicaid
NC01465OtherBCBS
NC0661Medicare ID - Type Unspecified