Basic Information
| Provider Information | |||||||||
| NPI: | 1740752989 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CARY ORTHOPAEDIC AND SPORTS MEDICINE SPECIALISTS, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1120 SE CARY PKWY STE 100 | ||||||||
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| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275187413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194674992 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1110 SE CARY PKWY STE 208 | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275187435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192970000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2018 | ||||||||
| LastUpdateDate: | 12/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | WHEELIN | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | REVENUE AND SPECIAL OPERATIONS DIR. | ||||||||
| AuthorizedOfficialTelephone: | 9194674992 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.