Individual
PAUL R MONCLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1141 N ROAD ST, SUITE I, ELIZABETH CITY, NC 27909-3354
(252) 338-0101
(252) 331-1598
Mailing address
1141 N ROAD ST, SUITE I, ELIZABETH CITY, NC 27909-3354
(252) 338-0101
(252) 331-1598
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
9901580
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139K3
BC/BS OF NC PROVIDER #
NC
01
—
56-1474922
TRICARE / CHAMPUS PROV #
NC
05
—
5900947
—
NC
01
—
E3607
MEDCOST PROVIDER NUMBER
NC
Enumeration date
01/19/2006
Last updated
02/10/2011
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