MEDICARE: CARY OB/GYN

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1538560966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARY OB/GYN

Provider Business Mailing Address
First Line	:	1501 YAMATO RD
Second Line	:	SUITE 200 WEST
City	:	BOCA RATON
State	:	FL
Zip	:	33431-4438
Country	:	US
Telephone Number	:	561-300-2410
Fax Number	:	561-953-4146

Provider Business Practice Location Address
First Line	:	550 NEW WAVERLY PL
Second Line	:	SUITE 200
City	:	CARY
State	:	NC
Zip	:	27518-7412
Country	:	US
Telephone Number	:	919-467-5941
Fax Number	:	919-655-0532

Authorized Official
Title or Position	:	DIRECTOR MANAGED CARE
Name	:	MS. KATHRYN GARRETT
Credential	:
Telephone Number	:	561-300-2410

Provider Enumeration Date	:	09/04/2014
Last Update Date	:	09/04/2014

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Practice Location Address:

550 NEW WAVERLY PL , SUITE 200
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Practice Location Address:

550 NEW WAVERLY PL STE 200
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Practice Location Address:

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Directions to “CARY OB/GYN ” Practice Location

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