MEDICARE: NEUROSURGICAL ASSOCIATES, P.C.

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	207T00000X	Neurological Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4063806	OTHER	NC	AETNA
2	0605385	OTHER	NC	UNITED HEALTHCARE
3	97486	OTHER	NC	MEDCOST
4	2070150	OTHER	NC	FIRST HEALTH
5	011GA	OTHER	NC	BCBS OF NC
6	706943	OTHER	NC	CHOICE CARE NETWORK
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144295270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROSURGICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	4201 LAKE BOONE TRL
Second Line	:	STE 202
City	:	RALEIGH
State	:	NC
Zip	:	27607-7512
Country	:	US
Telephone Number	:	919-235-0500
Fax Number	:	919-235-0505

Provider Business Practice Location Address
First Line	:	4201 LAKE BOONE TRL
Second Line	:	STE 202
City	:	RALEIGH
State	:	NC
Zip	:	27607-7512
Country	:	US
Telephone Number	:	919-235-0500
Fax Number	:	919-235-0505

Authorized Official
Title or Position	:	OWNER
Name	:	SAMUEL K ST CLAIR
Credential	:	MD
Telephone Number	:	919-235-0500

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	12/22/2010

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Directions to “NEUROSURGICAL ASSOCIATES, P.C. ” Practice Location

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