Healthcare Provider Details

I. General information

NPI: 1932402195
Provider Name (Legal Business Name): SOUTHEAST ANESTHESIOLOGY CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 INDEPENDENCE BLVD SUITE 200
WILMINGTON NC
28412
US

IV. Provider business mailing address

1305 WALT WHITMAN RD STE 300
MELVILLE NY
11747-4300
US

V. Phone/Fax

Practice location:
  • Phone: 910-442-1100
  • Fax: 910-442-1199
Mailing address:
  • Phone: 516-208-4250
  • Fax: 704-248-5537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDGAR C GARRABRANT III
Title or Position: PRESIDENT/DIRECTOR
Credential: MD
Phone: 754-247-4124