Individual
ERIC EDWARD CONOLOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
101 COSGROVE AVE STE 110, CHAPEL HILL, NC 27514
(919) 929-9612
Mailing address
DEPT. 453 PO BOX 1000, MEMPHIS, TN 38148-0001
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07896
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316484702
—
NC
01
—
NNK268A
MEDICARE PTAN
NC
Enumeration date
01/24/2017
Last updated
10/30/2023
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