MEDICARE: PINEHURST RHEUMATOLOGY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	2320331	OTHER	NC	MEDICARE PTAN ENDING 2/25/2009
3	CD8391	OTHER	NC	MEDICARE RAILROAD
7	2225603A	OTHER	NC	MEDICARE GROUP NEW PTAN 2/26/2009

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1881691277	OTHER	NC	MARTIN NPI
4	1013975598	OTHER	NC	GROUP NPI
5	1780681221	OTHER	NC	AUSTIN NPI
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	1710919683	OTHER	NC	SCHORN NPI
9	0136Y	OTHER	NC	BCBS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013975598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINEHURST RHEUMATOLOGY PA

Provider Business Mailing Address
First Line	:	4204 MURDOCKSVILLE ROAD
Second Line	:
City	:	WEST END
State	:	NC
Zip	:	27376-8871
Country	:	US
Telephone Number	:	910-255-0055
Fax Number	:	910-255-0060

Provider Business Practice Location Address
First Line	:	4204 MURDOCKSVILLE ROAD
Second Line	:
City	:	WEST END
State	:	NC
Zip	:	27376-8871
Country	:	US
Telephone Number	:	910-255-0055
Fax Number	:	910-255-0060

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KARA M MARTIN
Credential	:	MD
Telephone Number	:	910-255-0055

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	06/18/2012

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Directions to “PINEHURST RHEUMATOLOGY PA ” Practice Location

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