Basic Information
| Provider Information | |||||||||
| NPI: | 1871239525 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GYNECOLOGY AND LAPAROSCOPIC SURGEONS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12860 | ||||||||
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| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193340123 | ||||||||
| FaxNumber: | 9193340152 | ||||||||
| Practice Location | |||||||||
| Address1: | 10941 RAVEN RIDGE RD STE 109 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276146487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198477475 | ||||||||
| FaxNumber: | 9198477471 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2022 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | HERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | ERICA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5613002410 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.