Tristram, Debra A
Tristram, Debra A is an individual health care provider with primary practice located at 2150 Herbert Ct Ecu Physicians Pediatric Specialty Care Clinic, Greenville NC 27834-3736. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases, which is considered as her primary health care specialty. Tristram, Debra A can be contacted via phone (252) 744-5437.Contact Information
Primary practice address
2150 Herbert Ct Ecu Physicians Pediatric Specialty Care Clinic
Greenville NC 27834-3736
Phone: (252) 744-5437
Fax: (252) 744-1514
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases | 2080P0208X | 9801788 | North Carolina |
Profile Details
| NPI number | 1306829015 |
|---|---|
| LBN Legal business name | Tristram, Debra A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Mar 15th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306829015 | NPPES |
| North Carolina | Other | 11649 | BCBS NC |
| North Carolina | MEDICAID | 8911649 | BCBS NC |
| North Carolina | Other | 370015918 | BCBS NC |
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