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General NPI Number Information
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NPI Number | 1376752618
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Entity Type | Organization
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Legal Business Name | EASTERN ONCOLOGY & HEMATOLOGY
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 855 JOHNS HOPKINS DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7223
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Country | US
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Telephone | 252-830-1867
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Fax | 252-830-1003
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Provider Business Mailing Address
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Address Line | 855 JOHNS HOPKINS DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7223
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Country | US
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Telephone | 252-830-1867
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Fax | 252-830-1003
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Authorized Official
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Title or Position | OWNER
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Name | JORGE ABDALLAH
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Credential | MD
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Telephone | 252-830-1867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 34779
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License Number State | NC
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