VIDANT MEDICAL GROUP LLC NPI 1376049619

NPI Information

  • NPI: 1376049619
  • Provider Name: VIDANT MEDICAL GROUP LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: VIDANT ENDOSCOPY CENTER-KINSTON
  • CLIA Number: 34D2174616
  • Address: 701 DOCTORS DR STE N
    KINSTON, NC
    ZIP 28501
  • Phone: (252) 559-2200

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NPI Details

VIDANT MEDICAL GROUP LLC is an ambulatory surgical clinic center in Kinston, NC. VIDANT MEDICAL GROUP LLC NPI is 1376049619. The provider is registered as an organization entity type.
The provider Is Doing Business As Vidant Endoscopy Center-kinston.

The provider's business location address is:

701 DOCTORS DR STE N
KINSTON, NC
ZIP 28501-584
Phone: (252) 559-2200
Fax: (252) 522-5662

The provider's authorized official is Anthony Wayne Barholomew .
The authorized official title is Vp, Operactions and has the following contact phone number (252) 847-9067.

The CLIA number assigned to this NPI record is 34D2174616 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2018 and was last updated on 4/4/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalAS0122NORTH CAROLINAYes

What is NPI?

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This page was last updated on: 3/30/2025

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