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General NPI Number Information
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NPI Number | 1245515162
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Entity Type | Organization
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Legal Business Name | NEW HOPE WELLNESS AND TOTAL BARIATRIC CARE
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 9910 STRICKLAND RD SUITE 100
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City | RALEIGH
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State | NC
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Zip | 27615-2083
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Country | US
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Telephone | 919-861-6366
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Fax | 919-861-6367
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Provider Business Mailing Address
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Address Line | 9910 STRICKLAND RD SUITE 100
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City | RALEIGH
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State | NC
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Zip | 27615-2083
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Country | US
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Telephone | 919-861-6366
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Fax | 919-861-6367
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ERIC J DEMARIA
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Credential | MD
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Telephone | 919-861-6366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 200501604
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License Number State | NC
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