Provider Demographics
NPI:1619149473
Name:MIDGETT, JOHN DAMERON (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DAMERON
Last Name:MIDGETT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1202 MEDICAL CENTER DR STE 201-A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-1540
Mailing Address - Fax:910-431-4048
Practice Address - Street 1:1300 BRIDGE BARRIER RD
Practice Address - Street 2:
Practice Address - City:CAROLINA BEACH
Practice Address - State:NC
Practice Address - Zip Code:28428-3938
Practice Address - Country:US
Practice Address - Phone:910-458-4101
Practice Address - Fax:910-458-5617
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2024-11-18
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Provider Licenses
StateLicense IDTaxonomies
NC0010-01286363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant