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314 W Queen St Edenton NC 27932-1733 | |
| (252) 482-7774 | |
| (252) 482-7345 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 314 W Queen St, Edenton, North Carolina |
| Authorized Official Name and Position | Jill Marie Devine (OFFICE MANAGER) |
| Authorized Official Contact | 2524827774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
314 W Queen St Edenton NC 27932-1733 Ph: (252) 482-7774 | 314 W Queen St Edenton NC 27932-1733 Ph: (252) 482-7774 |
| NPI Number | 1225121221 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 12/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225121221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 8923374 (North Carolina) | Primary |
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