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Human Performance Lab 363 Ward Sports Medicine Building Greenville NC 27858 | |
(252) 744-3977 | |
(252) 744-4689 |
Full Name | |
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Speciality | Family Medicine - Sports Medicine |
Location | Human Performance Lab, Greenville, North Carolina |
Authorized Official Name and Position | Nicholas H. Benson (MEDICAL DIRECTOR) |
Authorized Official Contact | 2527447400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 751069 Charlotte NC 28275-1069 Ph: (252) 744-3253 | Human Performance Lab 363 Ward Sports Medicine Building Greenville NC 27858 Ph: (252) 744-3977 |
NPI Number | 1114978517 |
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Provider Enumeration Date | 05/12/2006 |
Last Update Date | 07/10/2008 |
Identifier | Type | State | Issuer |
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1114978517 | NPI | - | NPPES |
014A8 | Other | NC | BCBS NC GROUP PROVIDER # |
89014A8 | Medicaid | NC | |
03015 | Other | NC | BCBS NC GROUP PROVIDER # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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