Organization
ECEP II PA
Active
Other names
Eastern Carolina Emergency Physicians II PA
Organization subpart
No
Provider details
NPI number
Authorized official
DALE KEY (ADMINISTRATOR)
(910) 202-3363
Entity
Organization
Contact information
Practice address
507 E FREMONT ST, BURGAW, NC 28425-5131
(843) 237-3378
(843) 237-5073
Mailing address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 202-3363
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01456
BLUE CROSS BLUE SHIELD
NC
05
—
5905762
—
NC
05
—
7901456
—
NC
01
—
CI9263
RAILROAD MEDICARE
NC
05
—
QPB855
—
SC
Enumeration date
11/28/2006
Last updated
10/12/2020
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