Saint-Louis, Immacula

Saint-Louis, Immacula is an individual health care provider with primary practice located at 303 Green St E , Wilson NC 27893-4105. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Saint-Louis, Immacula can be contacted via phone (252) 243-9800.

Contact Information

Primary practice address
303 Green St E Wilson NC 27893-4105
Phone: (252) 243-9800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 2005-01289 North Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 151877 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D0088037 Maryland
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2005-01289 North Carolina

Profile Details

NPI number 1356449144
LBN Legal business name Saint-Louis, Immacula
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 27th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356449144 NPPES
Massachusetts MEDICAID 3196209

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