MEDICARE: SYLVA ORTHOPAEDIC ASSOCIATES, 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	332B00000X	Durable Medical Equipment & Medical Supplies	40411	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0364340001	OTHER	NC	MEDICARE DMERC REGION C

General Provider Information

NPI Number	:	1053313262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYLVA ORTHOPAEDIC ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	80 HEALTHCARE DR
Second Line	:	STE 203
City	:	SYLVA
State	:	NC
Zip	:	28779-5146
Country	:	US
Telephone Number	:	828-586-5531
Fax Number	:	828-586-5759

Provider Business Practice Location Address
First Line	:	80 HEALTHCARE DR
Second Line	:	STE 203
City	:	SYLVA
State	:	NC
Zip	:	28779-5146
Country	:	US
Telephone Number	:	828-586-5531
Fax Number	:	828-586-5759

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	LAWRENCE FRANCIS SUPIK
Credential	:	MD
Telephone Number	:	828-586-5531

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	06/18/2008

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Directions to “SYLVA ORTHOPAEDIC ASSOCIATES, PA ” Practice Location

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