Provider Demographics
NPI:1053509653
Name:THE DOCTORS OFFICE PA
Entity Type:Organization
Organization Name:THE DOCTORS OFFICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-354-6500
Mailing Address - Street 1:PO BOX 15409
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-5409
Mailing Address - Country:US
Mailing Address - Phone:252-672-7741
Mailing Address - Fax:252-672-7758
Practice Address - Street 1:7901 EMERALD DR
Practice Address - Street 2:SUITE 7
Practice Address - City:EMERALD ISLE
Practice Address - State:NC
Practice Address - Zip Code:28594-2846
Practice Address - Country:US
Practice Address - Phone:252-354-6500
Practice Address - Fax:252-354-5060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1053509653OtherBCBS
NC5908353Medicaid
NC5908353Medicaid