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Organization
EASTERN CAROLINA PAIN MANAGEMENT CENTER INC
Active
Organization
EASTERN CAROLINA PAIN MANAGEMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONI HARRIS MD (PHYSICIAN DIRECTOR)
(910) 251-8474
Entity
Organization
Contact information
Practice address
2035 VALLEYGATE DR, SUITE 201, FAYETTEVILLE, NC 28304-3688
(910) 323-8454
(910) 321-0656
Mailing address
PO BOX 3426, WILMINGTON, NC 28406-0426
(910) 251-8474
(910) 251-2202
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
35361
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39989
BLUE CROSS
NC
05
—
8939989
—
NC
Enumeration date
11/24/2006
Last updated
08/22/2020
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