Organization
EASTERN MEDICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP DOUGLAS MAYO M.D. (PRESIDENT)
(919) 734-1779
Entity
Organization
Contact information
Practice address
5413 US HIGHWAY 117 N, PIKEVILLE, NC 27863-9445
(919) 242-5271
(919) 242-5096
Mailing address
5413 US HIGHWAY 117 N, PIKEVILLE, NC 27863-9445
(919) 242-5271
(919) 242-5096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890112R
—
NC
01
—
CI3418
MEDICARE RAILROAD
NC
Enumeration date
06/01/2006
Last updated
01/04/2008
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