Organization
BLADEN EAST MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARVIN K GERALD (COO)
(910) 669-2221
Entity
Organization
Contact information
Practice address
16860 NC HIGHWAY 87 E, COUNCIL, NC 28434-8738
(910) 669-2226
Mailing address
PO BOX 186, COUNCIL, NC 28434-0186
(910) 669-2221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89015T6
—
NC
Enumeration date
03/19/2007
Last updated
06/11/2024
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