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Organization
OPEN WATER MEDICAL, PA
Active
Organization
OPEN WATER MEDICAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TISHA RAE SMITH (PRACTICE MANAGER)
(252) 728-5737
Entity
Organization
Contact information
Practice address
3106 ARENDELL STREET, MOREHEAD CITY, NC 28557-3202
(252) 808-2500
(252) 808-2501
Mailing address
1620 C LIVE OAK STREET, BEAUFORT, NC 28516-1583
(252) 728-5737
(252) 728-5739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30580
NC
Other
Enumeration date
06/08/2015
Last updated
02/24/2022
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