EASTERN NORTH CAROLINA MEDICAL GROUP PLLC NPI 1225367253

NPI Information

NPI: 1225367253
Provider Name: EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

CLIA Number: 34D0973053

Address:
1812 GLENDALE DR SW
SUITE B
WILSON, NC
ZIP 27893
Phone: (252) 291-3100
Get Directions

EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC is a pulmonary disease internal medicine in Wilson, NC. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC NPI is 1225367253. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1812 GLENDALE DR SW
SUITE B
WILSON, NC
ZIP 27893-676
Phone: (252) 291-3100
Fax: (252) 243-0599

The provider's authorized official is Denise H Bailey .
The authorized official title is Manager and has the following contact phone number (252) 451-2700.

The CLIA number assigned to this NPI record is 34D0973053 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2009 and was last updated on 4/4/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207Q00000X	Family Medicine		No
2	207R00000X	Internal Medicine		No
3	207RH0000X	Internal Medicine	Hematology	No
4	363L00000X	Nurse Practitioner		No
5	363A00000X	Physician Assistant		No
6	207RC0200X	Internal Medicine	Critical Care Medicine	No
7	208000000X	Pediatrics		No
8	207RP1001X	Internal Medicine	Pulmonary Disease	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	011C5	OTHER	NORTH CAROLINA	BCBS GROUP ID#
2	2344492	MEDICARE PIN	NORTH CAROLINA
3	89011C5	MEDICAID	NORTH CAROLINA
4	4059730001	MEDICARE NSC	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »