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General NPI Number Information
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NPI Number | 1437219979
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Entity Type | Organization
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Legal Business Name | EASTERN CAROLINA PEDIATRIC ASSOCIATES PC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 04/24/2009
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Provider Practice Location Address
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Address Line | 105 INDUSTRIAL WAY
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City | DARLINGTON
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State | SC
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Zip | 29532-0000
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Country | US
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Telephone | 843-395-0015
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Fax | 843-395-2573
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Provider Business Mailing Address
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Address Line | PO BOX 799
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City | DARLINGTON
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State | SC
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Zip | 29540-0799
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Country | US
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Telephone | 843-395-0015
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Fax | 843-395-2573
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES MORRISON FARISH
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Credential | M.D.
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Telephone | 843-395-0015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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