Provider Demographics
NPI:1104809730
Name:CAROLINA CARDIOVASCULAR SURGICAL ASSOCIATES P.A.
Entity type:Organization
Organization Name:CAROLINA CARDIOVASCULAR SURGICAL ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:H
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:919-231-6333
Mailing Address - Street 1:3000 NEW BERN AVE
Mailing Address - Street 2:STE 1100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610
Mailing Address - Country:US
Mailing Address - Phone:919-231-6333
Mailing Address - Fax:919-231-6334
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:STE 1100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-231-6333
Practice Address - Fax:919-231-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01229OtherBCBS
NC8901229Medicaid
NC01229OtherBCBS