Organization
OPEN WATER MEDICAL, PA
Active
Other names
East Carteret Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TISHA RAE SMITH (PRACTICE MANAGER)
(252) 728-5737
Entity
Organization
Contact information
Practice address
1620 LIVE OAK ST STE C, BEAUFORT, NC 28516-1582
(252) 728-5737
(252) 728-5739
Mailing address
1620 LIVE OAK ST STE C, BEAUFORT, NC 28516-1582
(252) 728-5737
(252) 728-5739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0159M
BCBS GROUP NUMBER
NC
01
—
0237L
DBA BCBS GROUP NUMBER
NC
05
—
890159M
—
NC
05
—
890237L
—
NC
Enumeration date
09/26/2006
Last updated
09/02/2025
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