Individual
DR. JOHN E. POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2041 VALLEYGATE DR, FAYETTEVILLE, NC 28304-3688
(910) 323-5203
(910) 223-1621
Mailing address
2041 VALLEYGATE DR, STE 101, FAYETTEVILLE, NC 28304-3746
(910) 321-2187
(910) 323-3650
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
9801021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137E
BCBS
—
01
—
7302311-001
CIGNA
—
05
—
891137E
—
NC
Enumeration date
07/09/2006
Last updated
08/30/2019
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