# BEAUFORT REGIONAL PHYSICIANS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHOCOWINITY FAMILY CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538275706
- **Authorized official:** MRS. SUSAN S GERARD (PHYSICIAN PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (252) 975-4203

## Contact information

- **Practice address:** 740 BRAGAW LANE, CHOCOWINITY, NC 27817-8415
- **Practice address phone:** (252) 946-9562
- **Practice address fax:** (252) 946-9071
- **Mailing address:** 740 BRAGAW LANE, CHOCOWINITY, NC 27817-8415
- **Mailing address phone:** (252) 946-9562
- **Mailing address fax:** (252) 946-9071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 01/19/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 022T3 | BLUE CROSS BLUE SHIELD | NC |
| 05 | — | 89016A5 | — | NC |