Provider Demographics
NPI:1487899589
Name:UROLOGY ASSOCIATES OF THE ALBEMARLE,P.C.
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES OF THE ALBEMARLE,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THWAITES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-335-0976
Mailing Address - Street 1:1134 N ROAD ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3365
Mailing Address - Country:US
Mailing Address - Phone:252-335-0976
Mailing Address - Fax:252-335-0310
Practice Address - Street 1:1134 N ROAD ST
Practice Address - Street 2:SUITE 5
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3365
Practice Address - Country:US
Practice Address - Phone:252-335-0976
Practice Address - Fax:252-335-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty