MEDICARE: NEUROLOGY OF CARY PLLC

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	174400000X	Specialist	35989	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	58809	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1902090244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY OF CARY PLLC

Provider Business Mailing Address
First Line	:	125 EDINBURGH DR
Second Line	:	SUITE 207
City	:	CARY
State	:	NC
Zip	:	27511-6484
Country	:	US
Telephone Number	:	919-297-0334
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 EDINBURGH DR
Second Line	:	SUITE 207
City	:	CARY
State	:	NC
Zip	:	27511-6484
Country	:	US
Telephone Number	:	919-297-0334
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MARTHA MILES
Credential	:
Telephone Number	:	919-297-0334

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	08/29/2007

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