MEDICARE: CAROLINA OTOLARYNGOLOGY CONSULTANTS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851340434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA OTOLARYNGOLOGY CONSULTANTS, PA

Provider Business Mailing Address
First Line	:	804 ENGLISH RD
Second Line	:	SUITE 200
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-6023
Country	:	US
Telephone Number	:	252-937-4100
Fax Number	:	252-937-4103

Provider Business Practice Location Address
First Line	:	804 ENGLISH RD
Second Line	:	SUITE 200
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-6023
Country	:	US
Telephone Number	:	252-937-4100
Fax Number	:	252-937-4103

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL DILLON CRAWFORD
Credential	:	M.D.
Telephone Number	:	252-937-4100

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/17/2007

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