Healthcare Provider Details

I. General information

NPI: 1023976362
Provider Name (Legal Business Name): CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 MULBERRY ST SW
LENOIR NC
28645-5702
US

IV. Provider business mailing address

256 10TH AVE NE STE C
HICKORY NC
28601-3882
US

V. Phone/Fax

Practice location:
  • Phone: 828-818-5100
  • Fax: 828-818-5179
Mailing address:
  • Phone: 828-322-2183
  • Fax: 828-979-3069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: BROOK FULMER
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 828-322-2183