Healthcare Provider Details

I. General information

NPI: 1720088255
Provider Name (Legal Business Name): JOHN ARTHUR GARSIDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 SE CARY PKWY STE 110
CARY NC
27511-5678
US

IV. Provider business mailing address

790 SE CARY PKWY STE 110
CARY NC
27511-5678
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-7400
  • Fax:
Mailing address:
  • Phone: 919-784-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number200000428
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number200000428
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: