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General NPI Number Information
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NPI Number | 1245567833
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Entity Type | Organization
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Legal Business Name | CAROLINA PLASTIC SURGERY OF FAYETTEVILLE PC
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 2153 VALLEYGATE DR STE 103
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3667
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Country | US
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Telephone | 910-323-1234
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Fax | 910-323-5444
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Provider Business Mailing Address
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Address Line | 2153 VALLEYGATE DR STE 103
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3667
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Country | US
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Telephone | 910-323-1234
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Fax | 910-323-5444
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SAIRA SAINI
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Credential |
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Telephone | 910-323-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 200901764
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License Number State | NC
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