Provider Demographics
NPI:1184625303
Name:EPPS, SEAN M (PAC)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:EPPS
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1041 NOELL LN
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2058
Practice Address - Country:US
Practice Address - Phone:252-451-2700
Practice Address - Fax:252-451-2702
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC104076363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7650718OtherAETNA ID
NCD6930OtherMEDCOST ID
NC2761596Medicare PIN
NCP00300833Medicare PIN
NC7650718OtherAETNA ID