Basic Information
| Provider Information | |||||||||
| NPI: | 1417394172 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | AUSTIN | ||||||||
| MiddleName: | ARCHIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 936857 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 311936857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106629500 | ||||||||
| FaxNumber: | 9106629501 | ||||||||
| Practice Location | |||||||||
| Address1: | 1415 PHYSICIANS DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284017338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106629500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2013 | ||||||||
| LastUpdateDate: | 08/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 191587 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 2016-00780 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.