MEDICARE: DR. ANDREW SEGARRA DC

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	111N00000X	Chiropractor	2589	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770577546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW SEGARRA DC

Provider Business Mailing Address
First Line	:	12020 UNIVERSITY CITY BLVD
Second Line	:
City	:	HARRISBURG
State	:	NC
Zip	:	28075-8466
Country	:	US
Telephone Number	:	704-455-2211
Fax Number	:	704-455-8246

Provider Business Practice Location Address
First Line	:	12020 UNIVERSITY CITY BLVD
Second Line	:
City	:	HARRISBURG
State	:	NC
Zip	:	28075-8466
Country	:	US
Telephone Number	:	704-455-2211
Fax Number	:	704-455-8246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	09/24/2012

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