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General NPI Number Information
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NPI Number | 1023423274
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA UNIVERSITY
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 517 MOYE BLVD
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City | GREENVILLE
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State | NC
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Zip | 27834-2849
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Country | US
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Telephone | 252-744-0766
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Fax | 252-744-0392
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Provider Business Mailing Address
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Address Line | PO BOX 751069
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City | CHARLOTTE
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State | NC
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Zip | 28275-1069
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JASON A FOLTZ
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Credential | D.O.
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Telephone | 252-744-1882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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