MEDICARE: ERIC PAUL BRESTEL M. D.

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	207K00000X	Allergy & Immunology Physician	31773	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	71600	OTHER	NC	MEDCOST
3	5511452	OTHER	NC	AETNA

General Provider Information

NPI Number	:	1952391369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC PAUL BRESTEL M. D.

Provider Business Mailing Address
First Line	:	1150 E ARLINGTON BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5866
Country	:	US
Telephone Number	:	252-756-1333
Fax Number	:	252-355-2068

Provider Business Practice Location Address
First Line	:	1150 E ARLINGTON BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5866
Country	:	US
Telephone Number	:	252-756-1333
Fax Number	:	252-355-2068

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	04/10/2008

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