Organization
CAROLINA HEART PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER B WAGNER D.O. (PRESIDENT)
(252) 757-1000
Entity
Organization
Contact information
Practice address
804 JOHNS HOPKINS DR, GREENVILLE, NC 27834-7222
(252) 757-1000
(252) 757-3045
Mailing address
804 JOHNS HOPKINS DR, GREENVILLE, NC 27834-7222
(252) 757-1000
(252) 757-3045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176A
GROUP NUMBER
NC
05
—
890176A
—
NC
01
—
CK0208
RR MEDICARE GROUP NUMBER
—
Enumeration date
04/26/2006
Last updated
09/07/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us