Provider Demographics
NPI:1952391369
Name:BRESTEL, ERIC PAUL (M D)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:PAUL
Last Name:BRESTEL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 E ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5866
Mailing Address - Country:US
Mailing Address - Phone:252-756-1333
Mailing Address - Fax:252-355-2068
Practice Address - Street 1:1150 E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5866
Practice Address - Country:US
Practice Address - Phone:252-756-1333
Practice Address - Fax:252-355-2068
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31773207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8918188Medicaid
NC71600OtherMEDCOST
NC5511452OtherAETNA
NC71600OtherMEDCOST
NC205005CMedicare PIN