Provider Demographics
NPI:1932151305
Name:CAROLINA EAR & HEARING CLINIC, PC
Entity Type:Organization
Organization Name:CAROLINA EAR & HEARING CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCELVEEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:919-876-4327
Mailing Address - Street 1:5900 SIX FORKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3838
Mailing Address - Country:US
Mailing Address - Phone:919-876-4327
Mailing Address - Fax:919-876-6800
Practice Address - Street 1:5900 SIX FORKS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3838
Practice Address - Country:US
Practice Address - Phone:919-876-4327
Practice Address - Fax:919-876-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCI7813OtherRAILROAD MEDICARE
NC3404298Medicaid
NC0290POtherBCBSNC
NCCI7813OtherRAILROAD MEDICARE
SC8905Medicare PIN