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General NPI Number Information
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NPI Number | 1902993710
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Entity Type | Organization
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Legal Business Name | EAST COAST MEDICAL PLLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 22545B HWY 17 N
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City | HAMPSTEAD
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State | NC
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Zip | 28443
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Country | US
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Telephone | 910-329-0300
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Fax | 910-329-0307
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Provider Business Mailing Address
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Address Line | 22545B HWY 17 N
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City | HAMPSTEAD
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State | NC
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Zip | 28443
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Country | US
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Telephone | 910-329-0300
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Fax | 910-329-0307
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Authorized Official
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Title or Position | OWNER
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Name | LISA KAY YOCUM
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Credential | PA-C
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Telephone | 910-329-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 39512
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License Number State | NC
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