| Chowan Pediatrics | |
|
203 Earnhardt Dr Edenton NC 27932-8401 | |
| (252) 482-7408 | |
| (252) 482-5529 |
| Full Name | Chowan Pediatrics |
|---|---|
| Speciality | Clinic/center |
| Location | 203 Earnhardt Dr, Edenton, North Carolina |
| Authorized Official Name and Position | Jeffrey N. Sackrison (PRESIDENT) |
| Authorized Official Contact | 2524826268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chowan Pediatrics Po Box 569 Edenton NC 27932-0569 Ph: (252) 482-7408 | Chowan Pediatrics 203 Earnhardt Dr Edenton NC 27932-8401 Ph: (252) 482-7408 |
| NPI Number | 1831152016 |
|---|---|
| Provider Enumeration Date | 04/10/2006 |
| Last Update Date | 07/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831152016 | NPI | - | NPPES |
| 012GF | Other | NC | BCBS PROVIDER # |
| 89012GF | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 200200691 (North Carolina) | Primary |
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