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Individual

MR. ETHAN WAYNE GARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1135 CARTHAGE ST, SANFORD, NC 27330-4162
(919) 774-2100
Mailing address
2919 ROANOKE AVE, NEW BERN, NC 28562-2543
(252) 497-6769

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
NC

Other

Enumeration date
06/09/2022
Last updated
06/09/2022
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