Provider Type Icon

OPEN WATER MEDICAL PA NPI 1669852372


NPI Information

NPI: 1669852372
Provider Name: OPEN WATER MEDICAL, PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D0715294

Address:
3106 ARENDELL STREET
MOREHEAD CITY, NC
ZIP 28557
Phone: (252) 808-2500
Get Directions

OPEN WATER MEDICAL, PA is a family medicine in Morehead City, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OPEN WATER MEDICAL, PA NPI is 1669852372. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3106 ARENDELL STREET
MOREHEAD CITY, NC
ZIP 28557-202
Phone: (252) 808-2500
Fax: (252) 808-2501

The provider's authorized official is Tisha Rae Smith .
The authorized official title is Practice Manager and has the following contact phone number (252) 728-5737.

The CLIA number assigned to this NPI record is 34D0715294 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/8/2015 and was last updated on 2/24/2022.


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
1207Q00000XFamily Medicine30580NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.