Individual
DR. CLINTON E FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 E 10TH ST, GREENVILLE, NC 27858-8798
(252) 847-4325
(252) 847-2034
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2000401497
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139TU
BCBS NC
NC
05
—
5900997
—
NC
01
—
P00245536
RAILROAD MEDICARE
NC
Enumeration date
11/30/2005
Last updated
02/09/2024
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