Healthcare Provider Details

I. General information

NPI: 1114998150
Provider Name (Legal Business Name): SANDHILLS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PAVILION WAY
SOUTHERN PINES NC
28387-4556
US

IV. Provider business mailing address

105 PAVILION WAY
SOUTHERN PINES NC
28387-4556
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

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