MEDICARE: DR. MARIA CARMEN EDAUGAL ESPIRITU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	200301457	NC
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	200301457	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	2337124	OTHER	NC	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	200301457	OTHER	NC	NCMB

General Provider Information

NPI Number	:	1538135942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA CARMEN EDAUGAL ESPIRITU M.D.

Provider Business Mailing Address
First Line	:	2425 N CENTER ST
Second Line	:	370
City	:	HICKORY
State	:	NC
Zip	:	28601-1320
Country	:	US
Telephone Number	:	704-269-9982
Fax Number	:	828-322-7921

Provider Business Practice Location Address
First Line	:	715 FAIRGROVE CHURCH RD SE
Second Line	:	SUITE 204
City	:	CONOVER
State	:	NC
Zip	:	28613-9290
Country	:	US
Telephone Number	:	888-898-7130
Fax Number	:	828-322-7921

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	03/12/2013

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Directions to “ DR. MARIA CARMEN EDAUGAL ESPIRITU M.D.” Practice Location

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