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General NPI Number Information
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NPI Number | 1336227958
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Entity Type | Organization
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Legal Business Name | CARY ADULT MEDICINE PLLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 930 SE CARY PARKWAY SUITE 200
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City | CARY
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State | NC
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Zip | 27518
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Country | US
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Telephone | 919-859-2566
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Fax |
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Provider Business Mailing Address
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Address Line | 930 SE CARY PARKWAY SUITE 200
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City | CARY
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State | NC
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Zip | 27518
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Country | US
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Telephone | 919-859-2566
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ROBERT JOHN RESNIK
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Credential | MD
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Telephone | 919-859-2566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 38831
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License Number State | NC
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