Healthcare Provider Details

I. General information

NPI: 1265697080
Provider Name (Legal Business Name): JOSEPH DODSON ELBEERY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOYE BLVD ECU PHYSICIANS: CARDIOTHORACIC SURGERY
GREENVILLE NC
27834-4300
US

IV. Provider business mailing address

5 DOGWOOD CT
GREENVILLE NC
27858-8414
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4400
  • Fax: 252-744-3987
Mailing address:
  • Phone: 252-412-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number35116
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: