| Dr. Jeff Severa, Internal Medicine | |
|
105 Mark Dr Suite B Edenton NC 27932-1704 | |
| (252) 482-3047 | |
| (252) 482-5061 |
| Full Name | Dr. Jeff Severa, Internal Medicine |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 105 Mark 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 |
|---|---|
| Dr. Jeff Severa, Internal Medicine Po Box 569 Edenton NC 27932-0569 Ph: (252) 482-3047 | Dr. Jeff Severa, Internal Medicine 105 Mark Dr Suite B Edenton NC 27932-1704 Ph: (252) 482-3047 |
| NPI Number | 1497719496 |
|---|---|
| Provider Enumeration Date | 04/14/2006 |
| Last Update Date | 07/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497719496 | NPI | - | NPPES |
| 89016CF | Medicaid | NC | |
| 016CF | Other | NC | BCBS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 200400743 (North Carolina) | Primary |
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