Provider Demographics
NPI:1265649107
Name:EASTERN CAROLINA WOMEN'S CENTER, PA
Entity Type:Organization
Organization Name:EASTERN CAROLINA WOMEN'S CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-633-3942
Mailing Address - Street 1:801 MCCARTHY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5237
Mailing Address - Country:US
Mailing Address - Phone:252-633-3942
Mailing Address - Fax:252-633-3332
Practice Address - Street 1:200 STONEBRIDGE SQ
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-9505
Practice Address - Country:US
Practice Address - Phone:252-447-8011
Practice Address - Fax:252-447-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2325772AMedicare ID - Type UnspecifiedMEDICARE GROUP ID #