Organization
CAROLINA COAST EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULI CLEM (CREDENTIALING SPECIALIST)
(770) 874-5452
Entity
Organization
Contact information
Practice address
607 BEAMAN ST, CLINTON, NC 28328-2603
(910) 590-8748
Mailing address
PO BOX 277982, ATLANTA, GA 30384-7982
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
08/24/2006
Last updated
08/22/2020
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