Provider Demographics
NPI:1992822738
Name:MCRAE, EUGENE B (SAC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:B
Last Name:MCRAE
Suffix:
Gender:M
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 7 LKS N
Mailing Address - Street 2:PO BOX 9
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9756
Mailing Address - Country:US
Mailing Address - Phone:910-673-9111
Mailing Address - Fax:910-673-6202
Practice Address - Street 1:1120 7 LKS N
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-9756
Practice Address - Country:US
Practice Address - Phone:910-673-9111
Practice Address - Fax:910-673-6202
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)