Organization
COASTAL EAR NOSE & THROAT ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD DWIGHT GRADY MD (PRESIDENT)
(252) 638-2515
Entity
Organization
Contact information
Practice address
3110 WELLONS BLVD, NEW BERN, NC 28562-5247
(252) 638-2515
(252) 638-8538
Mailing address
3110 WELLONS BLVD, NEW BERN, NC 28562-5247
(252) 638-2515
(252) 638-8538
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891157J
—
NC
05
—
891170N
—
NC
05
—
8936530
—
NC
05
—
8953662
—
NC
Enumeration date
06/03/2006
Last updated
01/21/2010
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