Provider Demographics
NPI:1184659732
Name:COASTAL HOSPITALISTS
Entity type:Organization
Organization Name:COASTAL HOSPITALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:910-792-9997
Mailing Address - Street 1:3807 PEACHTREE AVE
Mailing Address - Street 2:STE101
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6723
Mailing Address - Country:US
Mailing Address - Phone:910-792-9997
Mailing Address - Fax:910-792-9957
Practice Address - Street 1:3807 PEACHTREE AVE
Practice Address - Street 2:STE101
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6723
Practice Address - Country:US
Practice Address - Phone:910-792-9997
Practice Address - Fax:910-792-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2326443Medicare PIN