Provider Demographics
NPI:1649528662
Name:CAROLINAEAST PHYSICIANS
Entity type:Organization
Organization Name:CAROLINAEAST PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-633-8880
Mailing Address - Street 1:PO BOX 602522
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2522
Mailing Address - Country:US
Mailing Address - Phone:252-523-6000
Mailing Address - Fax:252-527-8500
Practice Address - Street 1:2503 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1632
Practice Address - Country:US
Practice Address - Phone:252-523-6000
Practice Address - Fax:252-527-8500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINAEAST PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-23
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty