Organization
COASTAL CAROLINA HEALTH CARE PA
Active
Other names
CCHC Central Lab
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN W NUCKOLLS (CEO)
(252) 514-6685
Entity
Organization
Contact information
Practice address
1020 MEDICAL PARK AVENUE, NEW BERN, NC 28562-5248
(252) 514-6685
(252) 514-2745
Mailing address
PO BOX 12248, NEW BERN, NC 28561-2248
(252) 514-6685
(252) 514-2745
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909118
—
NC
Enumeration date
01/17/2008
Last updated
02/01/2024
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