Healthcare Provider Details

I. General information

NPI: 1013868041
Provider Name (Legal Business Name): ENT SURGICAL CENTER OF THE CAROLINAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9610 PINEVILLE MATTHEWS RD
PINEVILLE NC
28134-7602
US

IV. Provider business mailing address

9610 PINEVILLE MATTHEWS RD
PINEVILLE NC
28134-7602
US

V. Phone/Fax

Practice location:
  • Phone: 417-861-1454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MCCARVILLE
Title or Position: ADMINISTRATOR
Credential: MPA
Phone: 417-861-1454