| Carolina Internal Medicine And Pediatrics | |
|
204 Malloy St Ste A Goldsboro NC 27534-4477 | |
| (919) 751-7665 | |
| (919) 651-1370 |
| Full Name | Carolina Internal Medicine And Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 204 Malloy St Ste A, Goldsboro, North Carolina |
| Authorized Official Name and Position | Van Lee Adams (PHYSICIAN/OWNER) |
| Authorized Official Contact | 9197517665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Internal Medicine And Pediatrics 204 Malloy St Ste A Goldsboro NC 27534-4477 Ph: (919) 751-7665 | Carolina Internal Medicine And Pediatrics 204 Malloy St Ste A Goldsboro NC 27534-4477 Ph: (919) 751-7665 |
| NPI Number | 1124460514 |
|---|---|
| Provider Enumeration Date | 07/25/2013 |
| Last Update Date | 07/25/2013 |
| Medicare PECOS PAC ID | 4082840715 |
|---|---|
| Medicare Enrollment ID | O20131202000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124460514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Van L Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588872964 PECOS PAC ID: 1355497298 Enrollment ID: I20110803000760 |
| Provider Name | Jalysa K Gavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972154318 PECOS PAC ID: 2860824422 Enrollment ID: I20200422002747 |
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