| Edenton Internal Medicine Pa | |
|
104 Mark Dr Edenton NC 27932-1756 | |
| (252) 482-5171 | |
| (252) 482-5173 |
| Full Name | Edenton Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 104 Mark Dr, Edenton, North Carolina |
| Authorized Official Name and Position | Joseph Ray Haskett (PRESIDENT) |
| Authorized Official Contact | 2524825171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edenton Internal Medicine Pa Po Box 1210 Edenton NC 27932-1210 Ph: (252) 482-5171 | Edenton Internal Medicine Pa 104 Mark Dr Edenton NC 27932-1756 Ph: (252) 482-5171 |
| NPI Number | 1104816396 |
|---|---|
| Provider Enumeration Date | 10/27/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104816396 | NPI | - | NPPES |
| 890127H | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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