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General NPI Number Information
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NPI Number | 1043555899
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Entity Type | Organization
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Legal Business Name | CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 149 W PARKER RD SUITE C
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City | MORGANTON
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State | NC
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Zip | 28655-4673
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Country | US
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Telephone | 828-322-2183
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Fax | 828-322-2389
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Provider Business Mailing Address
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Address Line | 256 10TH AVE NE STE C
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City | HICKORY
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State | NC
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Zip | 28601-3882
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Country | US
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Telephone | 828-322-2183
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Fax | 828-322-2389
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Authorized Official
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Title or Position | BUSINESS OFFICE
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Name | BROOK FULMER
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Credential |
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Telephone | 828-322-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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