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General NPI Number Information
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NPI Number | 1932402195
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Entity Type | Organization
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Legal Business Name | SOUTHEAST ANESTHESIOLOGY CONSULTANTS, PLLC
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 2520 INDEPENDENCE BLVD SUITE 200
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City | WILMINGTON
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State | NC
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Zip | 28412
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Country | US
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Telephone | 910-442-1100
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Fax | 910-442-1199
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Provider Business Mailing Address
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Address Line | 1305 WALT WHITMAN RD STE 300
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City | MELVILLE
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State | NY
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Zip | 11747-4300
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Country | US
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Telephone | 516-208-4250
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Fax | 704-248-5537
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | DR. EDGAR C GARRABRANT III
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Credential | MD
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Telephone | 754-247-4124
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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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