Healthcare Provider Details

I. General information

NPI: 1265361059
Provider Name (Legal Business Name): NORTH CAROLINA SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 KILDAIRE FARM RD STE 110
CARY NC
27511-6571
US

IV. Provider business mailing address

1700 KILDAIRE FARM RD STE 130
CARY NC
27511-6571
US

V. Phone/Fax

Practice location:
  • Phone: 919-897-5999
  • Fax: 919-897-5980
Mailing address:
  • Phone: 919-897-5999
  • Fax: 919-897-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SIDDHARTHA RAO
Title or Position: PRESIDENT
Credential: MD
Phone: 919-897-5999