1952363855 NPI number — ALAMANCE SURGICAL ASSOCIATES, P.A.

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 1952363855 NPI number — ALAMANCE SURGICAL ASSOCIATES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALAMANCE SURGICAL ASSOCIATES, P.A.
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:
1952363855
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1041 KIRKPATRICK RD
Provider Second Line Business Mailing Address:
STE 150
Provider Business Mailing Address City Name:
BURLINGTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27215-8148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-538-1888
Provider Business Mailing Address Fax Number:
336-538-1313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1041 KIRKPATRICK RD
Provider Second Line Business Practice Location Address:
STE 150
Provider Business Practice Location Address City Name:
BURLINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27215-8148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-538-1888
Provider Business Practice Location Address Fax Number:
336-538-1313
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BYRNETT
Authorized Official First Name:
MAUREEN
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OFFICE COORDINATOR
Authorized Official Telephone Number:
336-538-1888

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 790101F , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0101F . This is a "BLUE CROSS GROUP ID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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