Healthcare Provider Details

I. General information

NPI: 1073612842
Provider Name (Legal Business Name): THOMAS E BATES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3714 GUARDIAN AVE STE E
MOREHEAD CITY NC
28557-4322
US

IV. Provider business mailing address

PO BOX 5105
BELFAST ME
04915-5100
US

V. Phone/Fax

Practice location:
  • Phone: 252-247-2101
  • Fax: 252-247-4675
Mailing address:
  • Phone: 252-247-2101
  • Fax: 252-247-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number9600117
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number9600117
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: