Provider Demographics
NPI:1124835178
Name:CAROLINA PILONIDAL CENTER
Entity type:Organization
Organization Name:CAROLINA PILONIDAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WADIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-966-1674
Mailing Address - Street 1:400 ASHVILLE AVE STE 200B
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6134
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 ASHVILLE AVE STE 200B
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6134
Practice Address - Country:US
Practice Address - Phone:919-858-7020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH HEALTH PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-13
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty