Healthcare Provider Details

I. General information

NPI: 1467437897
Provider Name (Legal Business Name): VERONIKA ANN SURBER PA C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 05/11/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 FREEDOM WAY STE 2
HUBERT NC
28539-3647
US

IV. Provider business mailing address

PO BOX 103
HUBERT NC
28539-0103
US

V. Phone/Fax

Practice location:
  • Phone: 910-238-4268
  • Fax:
Mailing address:
  • Phone: 910-238-4268
  • Fax: 877-349-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number001000414
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-00414
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: