Healthcare Provider Details

I. General information

NPI: 1831151539
Provider Name (Legal Business Name): CAROLINA EAR, NOSE & THROAT-SINUS AND ALLERGY CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 10TH AVE NE
HICKORY NC
28601-3834
US

IV. Provider business mailing address

256 10TH AVE NE STE C
HICKORY NC
28601-3882
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-2183
  • Fax: 828-328-2838
Mailing address:
  • Phone: 828-322-2183
  • Fax: 828-328-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: BROOK FULMER
Title or Position: BUSINESS OFFICE
Credential:
Phone: 828-322-2183