MEDICARE: EASTERN CAROLINA EAR, NOSE & THROAT-HEAD & NECK SURGERY, INC

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	207400000X	NC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	02433	OTHER	NC	BCBS GROUP NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912957606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTERN CAROLINA EAR, NOSE & THROAT-HEAD & NECK SURGERY, INC

Provider Business Mailing Address
First Line	:	850 JOHNS HOPKINS DR
Second Line	:	POB 5007
City	:	GREENVILLE
State	:	NC
Zip	:	27834-7222
Country	:	US
Telephone Number	:	252-752-5227
Fax Number	:	252-752-1191

Provider Business Practice Location Address
First Line	:	850 JOHNS HOPKINS DR
Second Line	:	POB 5007
City	:	GREENVILLE
State	:	NC
Zip	:	27834-7222
Country	:	US
Telephone Number	:	252-752-5227
Fax Number	:	252-752-1191

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL S. CAMNITZ
Credential	:	M.D.
Telephone Number	:	252-752-5227

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	10/21/2014

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Directions to “EASTERN CAROLINA EAR, NOSE & THROAT-HEAD & NECK SURGERY, INC ” Practice Location

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