Organization
GREENVILLE INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO E. WAIVERS MD (PRESIDENT)
(252) 830-1680
Entity
Organization
Contact information
Practice address
2210 HEMBY LN, SUITE 101, GREENVILLE, NC 27834-3773
(252) 830-1680
(252) 830-0926
Mailing address
800 MOYE BLVD, GREENVILLE, NC 27834-3777
(252) 830-1680
(252) 830-0926
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
56908
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0169E
BCBS-NC
NC
05
—
890169E
—
NC
Enumeration date
01/10/2007
Last updated
04/29/2008
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