Provider Demographics
NPI:1013148063
Name:MONCLA, ALFRED M (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:M
Last Name:MONCLA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1141 N ROAD ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3354
Mailing Address - Country:US
Mailing Address - Phone:252-338-0101
Mailing Address - Fax:252-331-1598
Practice Address - Street 1:1141 N ROAD ST
Practice Address - Street 2:SUITE I
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3354
Practice Address - Country:US
Practice Address - Phone:252-338-0101
Practice Address - Fax:252-331-1598
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
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Provider Licenses
StateLicense IDTaxonomies
NC17727207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology