Edenton Internal Medicine PA
Internal Medicine in Edenton, NC. Organization (NPI-2).
NPI number1104816396
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1104816396
- Entity type
- Organization (NPI-2)
- Legal business name
- Edenton Internal Medicine PA
- Organization subpart
- No
- Enumeration date
- Oct 27, 2005
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
104 Mark DrEdenton, NC 27932-1756
Phone 252-482-5171 · Fax 252-482-5173
Mailing address
Po Box 1210Edenton, NC 27932-1210
Phone 252-482-5171 · Fax 252-482-5173
Authorized official
Joseph Ray Haskett
President
2524825171
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