MEDICARE: ORTHOPAEDIC SPECIALISTS OF NORTH CAROLINA, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1174849780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPAEDIC SPECIALISTS OF NORTH CAROLINA, PA

Provider Business Mailing Address
First Line	:	PO BOX 1107
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27588-1107
Country	:	US
Telephone Number	:	919-562-9410
Fax Number	:	919-562-2948

Provider Business Practice Location Address
First Line	:	1539 DABNEY DR
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-2907
Country	:	US
Telephone Number	:	252-460-6500
Fax Number	:	252-430-8115

Authorized Official
Title or Position	:	SECRETARY
Name	:	MARK WILLIAM GALLAND
Credential	:	MD
Telephone Number	:	919-562-9410

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	01/17/2018

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