Organization
CAROLINA ADULT MEDICINE, PA
Active
Organization
CAROLINA ADULT MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JOHN GRUCHACZ M.D. (PRESIDENT)
(252) 438-7777
Entity
Organization
Contact information
Practice address
568 RUIN CREEK RD, SUITE 002, HENDERSON, NC 27536-2880
(252) 438-7777
(252) 438-7190
Mailing address
568 RUIN CREEK RD, SUITE 002, HENDERSON, NC 27536-2880
(252) 438-7777
(252) 438-7190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9700258
NC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
9701734
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016G2
BCBS GROUP NUMBER
NC
05
—
89016G2
—
NC
Enumeration date
03/23/2006
Last updated
09/11/2025
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