Provider Demographics
NPI:1205130325
Name:AFFILIATED HEALTHCARE, PLC
Entity type:Organization
Organization Name:AFFILIATED HEALTHCARE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:AHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-916-7026
Mailing Address - Street 1:PO BOX 30303
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27833-0303
Mailing Address - Country:US
Mailing Address - Phone:252-916-7026
Mailing Address - Fax:252-672-8807
Practice Address - Street 1:3240 BURNT MILL DR
Practice Address - Street 2:SUITE 9
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2576
Practice Address - Country:US
Practice Address - Phone:252-916-7026
Practice Address - Fax:252-672-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500147174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty