Organization
COLUMBUS PEDIATRICS & ADOLESCENT CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COY RANDOLPH MATTHEWS M.D. (PRESIDENT OF CORPORATION)
(910) 642-2642
Entity
Organization
Contact information
Practice address
800 JEFFERSON ST, SUITE 116, WHITEVILLE, NC 28472-3710
(910) 642-2642
(910) 642-3346
Mailing address
800 JEFFERSON ST, SUITE 116, WHITEVILLE, NC 28472-3702
(910) 642-2642
(910) 642-3346
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
36388
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902340
—
NC
Enumeration date
03/27/2006
Last updated
02/07/2008
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