Basic Information
Provider Information
NPI: 1285697110
EntityType: 2
ReplacementNPI:  
OrganizationName: DOWN EAST MEDICAL ASSOCIATES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 306 MEDICAL PARK CT
Address2:  
City: MOREHEAD CITY
State: NC
PostalCode: 285574346
CountryCode: US
TelephoneNumber: 2522472013
FaxNumber: 2522477299
Practice Location
Address1: 306 MEDICAL PARK CT
Address2:  
City: MOREHEAD CITY
State: NC
PostalCode: 285574346
CountryCode: US
TelephoneNumber: 2522472013
FaxNumber: 2522477299
Other Information
ProviderEnumerationDate: 04/11/2006
LastUpdateDate: 05/22/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCCALLUM
AuthorizedOfficialFirstName: DEBORAH
AuthorizedOfficialMiddleName: WATSON
AuthorizedOfficialTitleorPosition: OFFICE MANAGER
AuthorizedOfficialTelephone: 2522472013
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 
207N00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansDermatology 
207RE0101X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

ID Information
IDTypeStateIssuerDescription
0123901NCBCBS OF NCOTHER
CD470001NCPALMETTO RAILROAD MEDICAREOTHER
790123905NC MEDICAID


Home