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General NPI Number Information
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NPI Number | 1467556472
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Entity Type | Organization
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Legal Business Name | CAROLINA HEARING GROUP INC
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Dates
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Enumeration Date | 09/11/2006
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 4201 LAKE BOONE TRL STE 105
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City | RALEIGH
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State | NC
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Zip | 27607-7511
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Country | US
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Telephone | 919-782-7112
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Fax | 919-789-9560
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Provider Business Mailing Address
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Address Line | 4201 LAKE BOONE TRL STE 105
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City | RALEIGH
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State | NC
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Zip | 27607-7511
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Country | US
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Telephone | 919-782-7112
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Fax | 919-789-9560
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | BRAD WAYNE BALDWIN
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Credential | AUD
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Telephone | 919-782-7112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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