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CRYSTAL COAST PAIN MANAGEMENT CENTER PLLC NPI 1790747988


NPI Information

NPI: 1790747988
Provider Name: CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC
Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
2111 NEUSE BLVD. SUITE J
NEW BERN, NC
ZIP 28560
Phone: (252) 636-0300
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CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC is a pain medicine anesthesiology in New Bern, NC. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC NPI is 1790747988. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2111 NEUSE BLVD. SUITE J
NEW BERN, NC
ZIP 28560
Phone: (252) 636-0300
Fax: (252) 636-0335

The provider's authorized official is Kirk Edward Harum .
The authorized official title is Owner/ Physician and has the following contact phone number (252) 636-0300.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 7/25/2018.


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
1207LP2900XAnesthesiologyPain MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18940362MEDICAIDNORTH CAROLINA

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

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