Provider Demographics
NPI:1821170945
Name:COSGROVE, BILLIE FOREHAND (MD)
Entity Type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:FOREHAND
Last Name:COSGROVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 GLEN MEADE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6023
Mailing Address - Country:US
Mailing Address - Phone:910-254-3544
Mailing Address - Fax:910-254-3543
Practice Address - Street 1:1814 GLEN MEADE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6023
Practice Address - Country:US
Practice Address - Phone:910-254-3544
Practice Address - Fax:910-254-3543
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300670207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC79361OtherMEDCOST ID
NC891067WMedicaid
NC1067WOtherBCBS ID
NC9300670OtherMEDICAL LICENSE
NC79361OtherMEDCOST ID
NC891067WMedicaid