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General NPI Number Information
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NPI Number | 1386622231
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Entity Type | Organization
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Legal Business Name | NORTHEAST ANESTHESIA AND PAIN SPECIALISTS PA
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Dates
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Enumeration Date | 01/01/2006
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 920 CHURCH ST N
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City | CONCORD
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State | NC
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Zip | 28025-2927
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Country | US
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Telephone | 704-783-3426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2000
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City | CONCORD
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State | NC
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Zip | 28026-2000
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Country | US
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Telephone | 704-403-1430
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Fax | 704-403-1158
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Authorized Official
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Title or Position | HEAD OF GROUP
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Name | WILLIAM GOGLIN
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Credential | MD
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Telephone | 704-403-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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