Healthcare Provider Details

I. General information

NPI: 1205804697
Provider Name (Legal Business Name): GOLDSBORO ENDOSCOPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

IV. Provider business mailing address

2705 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

V. Phone/Fax

Practice location:
  • Phone: 919-580-9111
  • Fax: 919-580-0988
Mailing address:
  • Phone: 919-580-9111
  • Fax: 919-580-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberAS0057
License Number StateNC

VIII. Authorized Official

Name: DR. V C MOTAPARTHY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 919-580-9111