Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Northside Park Gastroenterology & Endoscopy Center PLLC

Organization Specialist · NPI 1336422302

Northside Park Gastroenterology & Endoscopy Center PLLC provides Specialist services in Elizabeth City, North Carolina. Licensed in North Carolina. Registered with an NPI since 2011.

Licensed in
NC
In the registry since
2011
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

102 Northside Park Dr
Elizabeth City, NC 27909 Not confirmed with CMS for 14 years — call before visiting
Phone: (252) 335-4619
Fax: (252) 335-5744
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 9600169 (NC)
Specialist Taxonomy 174400000X · Licence 151718 (NC)

Record details

NPI number1336422302
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Sue — Physician/Owner · (252) 335-4619
NPI enumeratedSeptember 26, 2011
Last updated in NPPESOctober 22, 2011
Mailing address102 Northside Park Dr, Elizabeth City, NC 27909

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