Healthcare Provider Details

I. General information

NPI: 1801444302
Provider Name (Legal Business Name): CARTERET SURGICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4370 ARENDELL ST STE A
MOREHEAD CITY NC
28557-2800
US

IV. Provider business mailing address

3714 GUARDIAN AVE STE E
MOREHEAD CITY NC
28557-2975
US

V. Phone/Fax

Practice location:
  • Phone: 252-222-0204
  • Fax: 252-222-0433
Mailing address:
  • Phone: 252-222-5865
  • Fax: 252-247-9469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JAMIE HIGGINS
Title or Position: CREDENTIALING
Credential:
Phone: 252-222-5865