Graduated: 1986
NPI: 1770778573
Practice Locations (2)
SOUTHEASTERN REGIONAL MEDICAL CENTER
300 W 27TH ST
LUMBERTON, NC 283583075
9106715000
SOUTHEASTERN REGIONAL MEDICAL CENTER
300 W 27TH ST, SRMC IP PEDS CARE
LUMBERTON, NC 283583075
9106715000
Source: CMS National Downloadable File, September 2026.