Provider Demographics
NPI:1578677928
Name:MOSTELLAR, HENRY CURTIS III (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:CURTIS
Last Name:MOSTELLAR
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:POLLOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28573-0068
Mailing Address - Country:US
Mailing Address - Phone:252-635-3906
Mailing Address - Fax:252-224-0378
Practice Address - Street 1:701 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5239
Practice Address - Country:US
Practice Address - Phone:252-633-2081
Practice Address - Fax:252-633-3446
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC29148208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8961174Medicaid
NC61174OtherBLUE CROSS BLUE SHIELD
NC61174OtherBLUE CROSS BLUE SHIELD
NC213909Medicare ID - Type Unspecified