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NPI Code Detail

MEDICARE: NEUROSURGICAL ASSOCIATES, P.C.

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
1207T00000XNeurological Surgery Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14063806OTHERNCAETNA
20605385OTHERNCUNITED HEALTHCARE
397486OTHERNCMEDCOST
42070150OTHERNCFIRST HEALTH
5011GAOTHERNCBCBS OF NC
6706943OTHERNCCHOICE CARE NETWORK
7MEDICAID 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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