MEDICARE: EASTERN CAROLINA PATHOLOGY ASSOCIATES 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CL4298	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7046195	OTHER		MAMSI
2	22456	OTHER		MEDCOST
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0148J	OTHER	NC	BCBS OF NC

General Provider Information

NPI Number	:	1881682383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTERN CAROLINA PATHOLOGY ASSOCIATES PA

Provider Business Mailing Address
First Line	:	2693 FOREST HILLS RD SW STE B
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-8611
Country	:	US
Telephone Number	:	252-234-2841
Fax Number	:	252-234-9270

Provider Business Practice Location Address
First Line	:	2693 FOREST HILLS RD SW STE B
Second Line	:
City	:	WILSON
State	:	NC
Zip	:	27893-8611
Country	:	US
Telephone Number	:	252-234-2841
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BENJAMIN COULTER
Credential	:	MD
Telephone Number	:	252-234-2841

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	01/03/2020

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Practice Location Address:

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Directions to “EASTERN CAROLINA PATHOLOGY ASSOCIATES PA ” Practice Location

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