Healthcare Provider Details
I. General information
NPI: 1043209224
Provider Name (Legal Business Name): ERIC ARTHUR DEIGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/19/2005
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 MOYE BLVD
GREENVILLE NC
27834-4300
US
IV. Provider business mailing address
PO BOX 751069
CHARLOTTE NC
28275-1069
US
V. Phone/Fax
- Phone: 252-744-2350
- Fax: 252-744-5348
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 34590 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: