Healthcare Provider Details
I. General information
NPI: 1134378573
Provider Name (Legal Business Name): BEAUFORT COUNTY EMERGENCY PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2008
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
628 E 12TH ST EMERGENCY DEPARTMENT
WASHINGTON NC
27889-3409
US
IV. Provider business mailing address
861 SW 78TH AVE # 100-B
PLANTATION FL
33324-3273
US
V. Phone/Fax
- Phone: 877-693-5700
- Fax: 954-625-6034
- Phone: 877-693-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
S.
SCHILLINGER
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 877-693-5700