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Contact Information

REVIVAL MEDICAL WEIGHT LOSS CLINIC
1508 MILITARY CUTOFF RD STE 203
WILMINGTON, NC28403-5730
 Phone: 910-679-4312
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obesity Medicine

2083B0002X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for REVIVAL MEDICAL WEIGHT LOSS CLINIC

NPI Number 1689263345
LBN Legal business name REVIVAL MEDICAL WEIGHT LOSS CLINIC
Authorized official AMY WAINWRIGHT - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/15/2021
Last updated 01/15/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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