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General NPI Number Information
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NPI Number | 1598759896
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Entity Type | Organization
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Legal Business Name | EASTERN CAROLINA INTERNAL MEDICINE PA
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 137 MEDICAL LANE
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City | POLLOCKSVILLE
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State | NC
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Zip | 28573-0068
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Country | US
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Telephone | 252-633-1010
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Fax | 252-224-0378
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Provider Business Mailing Address
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Address Line | PO BOX 68
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City | POLLOCKSVILLE
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State | NC
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Zip | 28573-0068
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Country | US
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Telephone | 252-633-1010
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Fax | 252-224-0378
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | CRAIG A HOLTON
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Credential |
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Telephone | 252-633-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 39206
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License Number State | NC
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