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983 Us Highway 64 E Plymouth NC 27962-9216 | |
(252) 793-1010 | |
(252) 793-4113 |
Full Name | |
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Speciality | Family Medicine |
Location | 983 Us Highway 64 E, Plymouth, North Carolina |
Authorized Official Name and Position | Lindsey L White (PRESIDENT) |
Authorized Official Contact | 2523389451 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1134 N Road St Bldg.9 Elizabeth City NC 27909-3365 Ph: (252) 338-9451 | 983 Us Highway 64 E Plymouth NC 27962-9216 Ph: (252) 793-1010 |
NPI Number | 1710931993 |
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Provider Enumeration Date | 05/20/2006 |
Last Update Date | 01/08/2010 |
Medicare PECOS PAC ID | 8527028562 |
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Medicare Enrollment ID | O20041014000661 |
Identifier | Type | State | Issuer |
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1710931993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Beverly Ann Lewis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831160399 PECOS PAC ID: 4183707854 Enrollment ID: I20080219000345 |
Martin Tyrrell Washington District Health Dept Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 198 Nc Highway 45 N, Plymouth, NC 27962 Phone: 252-791-3119 Fax: 252-791-3159 | |