Individual
TAMMY DAVIS EBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10589 E NC HIGHWAY 97, SUITE 105, ROCKY MOUNT, NC 27803-9208
(252) 442-1807
(252) 442-1649
Mailing address
PO BOX 7867, ROCKY MOUNT, NC 27804-0867
(252) 451-2700
(252) 451-2702
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-00134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187577
MEDCOST ID
NC
01
—
429536
WELLPATH ID
NC
01
—
7173829
AETNA ID
NC
Enumeration date
08/31/2006
Last updated
04/25/2014
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