Healthcare Provider Details

I. General information

NPI: 1093772600
Provider Name (Legal Business Name): PHYSICIANS EAST, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 MCCRAE STREET
GRIFTON NC
28530
US

IV. Provider business mailing address

1850 W ARLINGTON BLVD
GREENVILLE NC
27834-5704
US

V. Phone/Fax

Practice location:
  • Phone: 252-524-5463
  • Fax: 252-524-0681
Mailing address:
  • Phone: 252-752-6101
  • Fax: 252-752-6600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNC AP 0000 1014
License Number StateNC

VIII. Authorized Official

Name: MRS. CINDY MCGEE
Title or Position: COO
Credential:
Phone: 252-752-6101