Provider Demographics
NPI:1275967564
Name:TOTAL HEALTH INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:TOTAL HEALTH INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLANGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-596-0061
Mailing Address - Street 1:606 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2604
Mailing Address - Country:US
Mailing Address - Phone:910-596-0061
Mailing Address - Fax:910-596-0062
Practice Address - Street 1:602 BEAMAN ST
Practice Address - Street 2:UNIT 606
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2604
Practice Address - Country:US
Practice Address - Phone:910-596-0061
Practice Address - Fax:910-596-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty