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NPI Code Detail

MEDICARE: NORTH CAROLINA SHOULDER AND ELBOW SURGERY AND SPORTS MEDICINE, PA

MEDICARE: NORTH CAROLINA SHOULDER AND ELBOW SURGERY AND SPORTS MEDICINE, 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
1174400000XSpecialist2006-01004NC

General Provider Information

NPI Number : 1730480559
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH CAROLINA SHOULDER AND ELBOW SURGERY AND SPORTS MEDICINE, PA
Provider Business Mailing Address
First Line : 6019 OLEANDER DR STE 200B
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-4813
Country : US
Telephone Number : 910-791-0313
Fax Number : 910-454-0011
Provider Business Practice Location Address
First Line : 6019 OLEANDER DR STE 200B
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-4813
Country : US
Telephone Number : 910-791-0313
Fax Number : 910-454-0011
Authorized Official
Title or Position : PRESIDENT
Name : DR. SHERMAN AUSTIN YEARGAN III
Credential : M.D.
Telephone Number : 910-454-0010
Provider Enumeration Date : 11/10/2010
Last Update Date : 11/11/2010

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Directions to “NORTH CAROLINA SHOULDER AND ELBOW SURGERY AND SPORTS MEDICINE, PA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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