Organization
EAST CAROLINA PSYCHIATRIC CONSULTANTS,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUTHIAH K. SABANAYAGAM M.D. (OWNER)
(919) 735-9119
Entity
Organization
Contact information
Practice address
916 ELEVENTH ST, GOLDSBORO, NC 27534-1616
(919) 735-9119
(919) 735-9120
Mailing address
916 ELEVENTH ST, GOLDSBORO, NC 27534-1616
(919) 735-9119
(919) 735-9120
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31639
NC
2084P0802X
Addiction Psychiatry Physician
31639
NC
2084P0804X
Child & Adolescent Psychiatry Physician
31639
NC
2084P0805X
Geriatric Psychiatry Physician
31639
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019JV
BCBS
NC
05
—
5909195
—
NC
01
—
61101
HUMANA
NE
Enumeration date
06/05/2007
Last updated
07/02/2008
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