Organization
CRYSTAL COAST PODIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JOHN BOBROWSKI D.P.M. (MANAGING MEMBER)
(252) 638-4700
Entity
Organization
Contact information
Practice address
3109 TRENT RD, NEW BERN, NC 28562-5736
(252) 638-4700
(252) 638-5766
Mailing address
3109 TRENT RD, NEW BERN, NC 28562-5736
(252) 638-4700
(252) 638-5766
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
417
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800U
BCBS
NC
05
—
790800U
—
NC
Enumeration date
12/29/2006
Last updated
02/10/2010
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