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General NPI Number Information
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NPI Number | 1790225936
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA SURGICAL, P.A.
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 508 JEFFERSON ST
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City | WHITEVILLE
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State | NC
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Zip | 28472-3634
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Country | US
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Telephone | 910-640-2480
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Fax | 910-640-2487
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Provider Business Mailing Address
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Address Line | 1048 TERRACE DR
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City | MARION
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State | VA
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Zip | 24354-4138
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Country | US
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Telephone | 276-783-1827
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Fax | 276-783-2879
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Authorized Official
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Title or Position | PHYSCIAN/OWNER
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Name | HUGH DANIEL
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Credential | MD
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Telephone | 910-640-7035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 33977
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License Number State | NC
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