=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245202142
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SALISBURY SURGICAL ASSOCIATES, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 911 W HENDERSON ST SUITE 410
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28144-2700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-637-2750
-----------------------------------------------------
Fax | 704-637-5514
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 911 W HENDERSON STREET SUITE 410
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28144-2700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-637-2750
-----------------------------------------------------
Fax | 704-637-5514
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER
-----------------------------------------------------
Name | MR. LEON B NEWMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 704-637-2750
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------