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NPI 1265593131

NPI 1265593131 : BEAUFORT REGIONAL PHYSICIANS,LLC : WASHINGTON, NC

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General NPI Number Information
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    NPI Number           |    1265593131
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    Entity Type          |    Organization 
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    Legal Business Name  |    BEAUFORT REGIONAL PHYSICIANS,LLC 
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Dates
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    Enumeration Date     |    12/13/2006
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    Last Update Date     |    01/19/2011
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Provider Practice Location Address
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    Address Line         |    1207 HIGHLAND DR 
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    City                 |    WASHINGTON
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    State                |    NC
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    Zip                  |    27889-3405
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    Country              |    US
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    Telephone            |    252-946-6515
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1207 HIGHLAND DR 
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    City                 |    WASHINGTON
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    State                |    NC
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    Zip                  |    27889-3405
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    Country              |    US
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    Telephone            |    252-946-6515
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     SUSAN S GERARD 
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    Credential           |    
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    Telephone            |    252-975-4203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery Physician
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    License Number       |    
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    License Number State |    
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