Healthcare Provider Details

I. General information

NPI: 1043451966
Provider Name (Legal Business Name): VITO V CIRIGLIANO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 REGIONAL DR
PINEHURST NC
28374-8850
US

IV. Provider business mailing address

205 PAGE RD
PINEHURST NC
28374-8749
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-9207
  • Fax: 910-295-3432
Mailing address:
  • Phone: 910-295-9207
  • Fax: 910-235-3432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2015-02086
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDOS1330
License Number StateHI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: