1831420785 NPI number — SWISS SPINE CLINIC PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831420785 NPI number — SWISS SPINE CLINIC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWISS SPINE CLINIC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831420785
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3100 NC HIGHWAY 55 STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27519-8427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-589-0909
Provider Business Mailing Address Fax Number:
919-589-0199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 NC HIGHWAY 55 STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27519-8427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-589-0909
Provider Business Practice Location Address Fax Number:
919-589-0199
Provider Enumeration Date:
01/15/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUGERLI
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
HANS
Authorized Official Title or Position:
OWNER/CLINIC DIRECTOR
Authorized Official Telephone Number:
919-589-0909

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  3955 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)