Organization
EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC
Active
Organization
EASTERN NORTH CAROLINA MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE H BAILEY (MANAGER)
(252) 451-2700
Entity
Organization
Contact information
Practice address
3400 N WESLEYAN BLVD, ROCKY MOUNT, NC 27804-8699
(252) 985-5187
(252) 451-2702
Mailing address
PO BOX 7867, ROCKY MOUNT, NC 27804-0867
(252) 451-2700
(252) 451-2702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011C5
—
NC
Enumeration date
02/15/2008
Last updated
04/04/2012
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