Healthcare Provider Details

I. General information

NPI: 1912233412
Provider Name (Legal Business Name): CAROLINA SLEEP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2009
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2459 EMERALD PL SUITE 102
GREENVILLE NC
27834-5732
US

IV. Provider business mailing address

2459 EMERALD PL SUITE 102
GREENVILLE NC
27834-5732
US

V. Phone/Fax

Practice location:
  • Phone: 252-757-3939
  • Fax: 252-757-3973
Mailing address:
  • Phone: 252-757-3939
  • Fax: 252-757-3973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number10567
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LEE ALAN SURKIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 252-757-3939