Healthcare Provider Details

I. General information

NPI: 1912835877
Provider Name (Legal Business Name): SANDHILLS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 N ELM ST
LUMBERTON NC
28358-2984
US

IV. Provider business mailing address

105 PAVILION WAY
SOUTHERN PINES NC
28387-4556
US

V. Phone/Fax

Practice location:
  • Phone: 910-674-4203
  • Fax: 910-674-4213
Mailing address:
  • Phone: 910-692-2444
  • Fax: 910-692-3651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPH ROBERT DIASIO
Title or Position: PARTNER
Credential:
Phone: 910-692-2444