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Organization
BEAUFORT REGIONAL PHYSICIANS, LLC
Active
Organization
BEAUFORT REGIONAL PHYSICIANS, LLC
Active
Other names
CHOCOWINITY FAMILY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN S GERARD (PHYSICIAN PRACTICE ADMINISTRATOR)
(252) 975-4203
Entity
Organization
Contact information
Practice address
740 BRAGAW LANE, CHOCOWINITY, NC 27817-8415
(252) 946-9562
(252) 946-9071
Mailing address
740 BRAGAW LANE, CHOCOWINITY, NC 27817-8415
(252) 946-9562
(252) 946-9071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022T3
BLUE CROSS BLUE SHIELD
NC
05
—
89016A5
—
NC
Enumeration date
08/21/2006
Last updated
01/19/2011
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