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General NPI Number Information
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NPI Number | 1619275252
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Entity Type | Organization
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Legal Business Name | EASTERN CAROLINA CARDIOVASCULAR
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 5136 N CROATAN HWY
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City | KITTY HAWK
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State | NC
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Zip | 27949-3988
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Country | US
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Telephone | 252-255-6080
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Fax | 252-255-6089
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Provider Business Mailing Address
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Address Line | 5136 N CROATAN HWY
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City | KITTY HAWK
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State | NC
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Zip | 27949-3988
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Country | US
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Telephone | 252-255-6080
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Fax | 252-255-6089
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINDSEY L. WHITE
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Credential | M.D.
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Telephone | 252-255-6089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | NC
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