Organization
EASTERN ENT SINUS AND ALLERGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN MCCULLEN (PRACTICE ADMINISTRATOR)
(919) 735-9146
Entity
Organization
Contact information
Practice address
2707 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9458
(919) 735-9146
(919) 735-0582
Mailing address
2707 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9458
(919) 735-9146
(919) 735-0582
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YS0012X
Sleep Medicine (Otolaryngology) Physician
Primary
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01642
BCBSNC
NC
05
—
8901642
—
NC
Enumeration date
06/22/2006
Last updated
02/08/2010
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