ODIBO MEDICAL GROUP PLLC (NPI# 1710334503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710334503 |
| Entity Type | Organization |
| Organization Name | ODIBO MEDICAL GROUP PLLC |
| Practice Address |
508 John S Mosby Dr Wilmington NC 28412-7121 |
| Mailing Address |
1099 Medical Center Dr Unit 100-a Wilmington NC 28401-7346 |
| Practice Telephone | 9737277409 |
| Mailing Telephone | 9737277409 |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2016-05-21 |
| Authorized Official Name | DR. MICHAEL C ODIBO (FOUNDER & PRESIDENT) |
| Authorized Official Telephone | 9737277409 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
2015-01360 | NC | Ambulatory Health Care Facilities |
| Street Address |
508 JOHN S MOSBY DR |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28412-7121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891357166 | Alexandra Palamaru | Dentist | 2759, 6132 Carolina Beach Rd., 6, Wilmington, NC 28412 | 2019-07-08 |
| 1447640115 | Carrie Anne Emory | Physician Assistant | 1124 Gallery Park Blvd, #200, Wilmington, NC 28412 | 2015-02-02 |
| 1144639295 | Christina Marie Terry | Physical Therapist | 7842 Champlain Dr, Wilmington, NC 28412 | 2014-08-03 |
| 1972889715 | New Hanover House, LLC | Assisted Living Facility | 3915 Stedwick Court, Wilmington, NC 28412 | 2011-10-25 |
| 1538440672 | Celine Adair | Marriage & Family Therapist | 9809 River Rd, Wilmington, NC 28412 | 2011-09-02 |
| 1033412267 | American Anesthesiology of North Carolina, Pllc | Anesthesiology | 2520 Independence Blvd, Suite 200, Wilmington, NC 28412 | 2010-12-09 |
| 1932418357 | Dale Autry | Pharmacist | 3625 South College Road, Wilmington, NC 28412 | 2010-10-04 |
| 1528390762 | Sheila Flynn | Counselor | 710 St. Andrews Dr. #18, Wilmington, NC 28412 | 2010-02-12 |
| 1952563686 | Stephen Rolfe Wells | Anesthesiology | 2520 Independence Boulevard, Suite 200, Wilmington, NC 28412 | 2008-06-25 |
| 1396902722 | Henry D Browning Iv | Dentist | 604 Junction Creek, Wilmington, NC 28412 | 2008-05-22 |
| Find all providers in zip 28412 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1750541322 | Sea Breeze Health Center Inc | Clinic/Center | 123 E F St Unit F, Wilmington, CA 90744-5817 | 2008-06-16 |
| 1457437832 | Singson Medical Group Pa | Clinic/Center | 1021 Gilpin Avenue, Suite 104, Wilmington, DE 19806 | 2006-10-28 |
| 1932194586 | Wilmington Community Clinic | Clinic/Center | 1009 N Avalon Blvd, Wilmington, CA 90744-4505 | 2005-09-20 |
| 1285191494 | Precision Care & Wellness, LLC | Clinic/Center | 4001 Miller Rd Ste 1, Wilmington, DE 19802-1961 | 2019-02-24 |
| 1861925042 | Southbridge Medical Advisory Council, Inc. | Clinic/Center | 1100 S Broom St, Wilmington, DE 19805-4585 | 2017-04-05 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28412 |
Please comment or provide details below to improve the information on ODIBO MEDICAL GROUP PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.