Organization
CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INC
Active
Parent organization
CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINA ORTHOPEDIC AND SPORTS MEDICINE INC
Authorized official
DAWN D GARRETT (EXECUTIVE DIRECTOR)
(252) 634-2676
Entity
Organization
Contact information
Practice address
925 E MAIN ST, SUITE 50, HAVELOCK, NC 28532-2374
(252) 634-2676
(252) 633-3502
Mailing address
738 NEWMAN RD, NEW BERN, NC 28562-5238
(252) 634-2676
(252) 633-3502
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
142144
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019K4
BCBS
NC
01
—
047H3
BCBS DME
NC
05
—
5908528
—
NC
Enumeration date
08/28/2007
Last updated
07/08/2008
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