Organization
VIDANT MEDICAL GROUP LLC
Active
Organization
VIDANT MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY W BARTHOLOMEW (VP OPERATIONS OF ECU HEALTH PHYSICI)
(252) 847-9067
Entity
Organization
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-2181
(252) 847-2213
Mailing address
PO BOX 749249, ATLANTA, GA 30374-9249
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018YM
BLUE CROSS BLUE SHIELD
NC
05
—
5906333
—
NC
05
—
5912190
—
NC
Enumeration date
10/04/2006
Last updated
02/05/2026
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