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General NPI Number Information
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NPI Number | 1043421076
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC SPECIALISTS OF NORTH CAROLINA, P.A.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 01/16/2018
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Provider Practice Location Address
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Address Line | 200 W PARKVIEW DR STE B
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City | HENDERSON
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State | NC
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Zip | 27536-5958
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Country | US
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Telephone | 919-562-9410
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Fax | 919-562-9248
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Provider Business Mailing Address
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Address Line | PO BOX 1107
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City | WAKE FOREST
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State | NC
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Zip | 27588-1107
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Country | US
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Telephone | 919-562-9410
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Fax | 919-562-2948
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Authorized Official
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Title or Position | SECRETARY
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Name | MARK WILLIAM GALLAND
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Credential | MD
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Telephone | 919-562-9410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | NC
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