Provider Demographics
NPI:1508885211
Name:AGUILAR, CELIA MAE (MD)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:MAE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELI
Other - Middle Name:M
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 634706
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4800 S CROATAN HWY
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9704
Practice Address - Country:US
Practice Address - Phone:252-449-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0098-01312207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13393OtherBLUE CROSS
NC8913393Medicaid
NCP00342821OtherMEDICARE RAILROAD
H89407Medicare UPIN
NC2020251AMedicare PIN