Provider Demographics
NPI:1124657663
Name:CARDIOSLEEP DIAGNOSTICS
Entity type:Organization
Organization Name:CARDIOSLEEP DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-902-5678
Mailing Address - Street 1:1862 OLD FORT RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9373
Mailing Address - Country:US
Mailing Address - Phone:252-902-5678
Mailing Address - Fax:252-329-2891
Practice Address - Street 1:1862 OLD FORT RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-9373
Practice Address - Country:US
Practice Address - Phone:252-902-5678
Practice Address - Fax:252-329-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty