# SOUTHEASTERN REGIONAL PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southeastern Maternal Fetal Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336797349
- **Authorized official:** ELLA HUNT (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (910) 737-3147

## Contact information

- **Practice address:** 4901 DAWN DR STE 1200, LUMBERTON, NC 28360-0004
- **Practice address phone:** (910) 671-4214
- **Practice address fax:** (910) 671-4215
- **Mailing address:** 2002 N CEDAR ST STE B, LUMBERTON, NC 28358-3926
- **Mailing address phone:** (910) 272-3048
- **Mailing address fax:** (910) 738-3764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2019
- **Last updated:** 10/08/2020