Individual
DAN ECCLESTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 WELLESLEY TRADE LN, CARY, NC 27519-5576
(919) 363-7546
(919) 363-3616
Mailing address
200 WELLESLEY TRADE LN, CARY, NC 27519-5576
(919) 363-7546
(919) 363-3616
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102547
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198486
MEDCOST
NC
Enumeration date
10/23/2006
Last updated
08/29/2014
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