Organization
EASTERN CAROLINA PAIN MANAGEMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONI HARRIS MD (PHYSICIAN DIRECTOR)
(910) 251-8474
Entity
Organization
Contact information
Practice address
2035 VALLEYGATE DR, SUITE 201, FAYETTEVILLE, NC 28304-3688
(910) 323-8454
(910) 321-0656
Mailing address
PO BOX 3426, WILMINGTON, NC 28406-0426
(910) 251-8474
(910) 251-2202
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
35361
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39989
BLUE CROSS
NC
05
—
8939989
—
NC
Enumeration date
11/24/2006
Last updated
08/22/2020
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