Provider Demographics
NPI:1700288776
Name:SEASHORE WOMEN'S HEALTH, PLLC
Entity Type:Organization
Organization Name:SEASHORE WOMEN'S HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ANTONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-622-3789
Mailing Address - Street 1:911 CAROLINA SANDS DR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28428-4618
Mailing Address - Country:US
Mailing Address - Phone:910-622-3789
Mailing Address - Fax:
Practice Address - Street 1:3720 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6147
Practice Address - Country:US
Practice Address - Phone:910-622-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty