MEDICARE: TATE GRANT SAUREY MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207W00000X	Ophthalmology Physician	2023-01163	NC

General Provider Information

NPI Number	:	1932661162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATE GRANT SAUREY MD

Provider Business Mailing Address
First Line	:	103 COX BLVD
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9478
Country	:	US
Telephone Number	:	919-734-8440
Fax Number	:	919-734-9387

Provider Business Practice Location Address
First Line	:	3515 TRENT RD STE 9
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2220
Country	:	US
Telephone Number	:	252-514-2155
Fax Number	:

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

Provider Enumeration Date	:	04/05/2019
Last Update Date	:	04/19/2024

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