Organization
EASTERN CAROLINA GERIATRIC ASSOCIATES AND FAMILY CARE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN WALLACE FERGUSON M.D. (PRESIDENT)
(252) 332-6484
Entity
Organization
Contact information
Practice address
105 COMMERCE STREET, POWELLSVILLE, NC 27967-0040
(252) 332-6484
(252) 332-1660
Mailing address
105 COMMERCE STREET, PO BOX 40, POWELLSVILLE, NC 27967
(252) 332-6484
(252) 332-1660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36700
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8931664
—
NC
Enumeration date
03/12/2009
Last updated
03/12/2009
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