Organization
BEAUFORT REGIONAL PHYSICIANS, LLC
Active
Other names
Coastal GI
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN S GERARD (PHYSICIAN PRACTICE ADMINISTRATOR)
(252) 975-4203
Entity
Organization
Contact information
Practice address
606 E. 12TH STREET, WASHINGTON, NC 27889-3409
(252) 940-6160
Mailing address
606 E. 12TH STREET, WASHINGTON, NC 27889-3409
(252) 940-6160
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022TM
BLUE CROSS BLUE SHIELD
NC
05
—
5950363
—
NC
Enumeration date
10/18/2007
Last updated
01/19/2011
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