EASTERN CAROLINA EAR, NOSE & THROAT-HEAD & NECK SURGERY, INC

Provider Demographics

• NPI: 1912957606
• Name: EASTERN CAROLINA EAR, NOSE & THROAT-HEAD & NECK SURGERY, INC
• Entity Type: Organization
• Organization Name: EASTERN CAROLINA EAR, NOSE & THROAT-HEAD & NECK SURGERY, INC
• Other - Org Name: PITT EAR, NOSE & THROAT - HEAD & NECK, SURGERY
• Other - Org Type: Former Legal Business Name
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - Prefix: DR
• Authorized Official - First Name: PAUL
• Authorized Official - Middle Name: S
• Authorized Official - Last Name: CAMNITZ
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 252-752-5227
• Mailing Address - Street 1: 850 JOHNS HOPKINS DR
• Mailing Address - Street 2: POB 5007
• Mailing Address - City: GREENVILLE
• Mailing Address - State: NC
• Mailing Address - Zip Code: 27834-7222
• Mailing Address - Country: US
• Mailing Address - Phone: 252-752-5227
• Mailing Address - Fax: 252-752-1191
• Practice Address - Street 1: 850 JOHNS HOPKINS DR
• Practice Address - Street 2: POB 5007
• Practice Address - City: GREENVILLE
• Practice Address - State: NC
• Practice Address - Zip Code: 27834-7222
• Practice Address - Country: US
• Practice Address - Phone: 252-752-5227
• Practice Address - Fax: 252-752-1191
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-11
• Last Update Date: 2014-10-21

Provider Licenses

State	License ID	Taxonomies
NC	207400000X	174400000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	174400000X	Other Service Providers	Specialist		Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NC	7951990	Medicaid
NC	7910476	Medicaid
NC	8920880	Medicaid
NC	02433	Other	BCBS GROUP NUMBER
NC	89126N7	Medicaid
NC	89131G9	Medicaid
NC	8911275	Medicaid
NC	E10602	Medicare UPIN
NC	G54287	Medicare UPIN
NC	H34640	Medicare UPIN
NC	7951990	Medicaid
NC	G31210	Medicare UPIN
NC	8911275	Medicaid
NC	2280486	Medicare ID - Type Unspecified	MEDICARE
NC	2250711	Medicare ID - Type Unspecified	MEDICARE
NC	2000488	Medicare ID - Type Unspecified	MEDICARE
NC	89131G9	Medicaid
NC	89126N7	Medicaid
NC	02433	Other	BCBS GROUP NUMBER
NC	205241	Medicare ID - Type Unspecified	MEDICARE