MEDICARE: CARTERET SURGICAL ASSOCIATES P.A.

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	332900000X	Non-Pharmacy Dispensing Site

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

General Provider Information

NPI Number	:	1912323189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTERET SURGICAL ASSOCIATES P.A.

Provider Business Mailing Address
First Line	:	534 N 35TH ST
Second Line	:	SUITE A
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-3182
Country	:	US
Telephone Number	:	252-773-0617
Fax Number	:	252-726-1805

Provider Business Practice Location Address
First Line	:	534 N 35TH ST
Second Line	:	SUITE A
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-3182
Country	:	US
Telephone Number	:	252-773-0614
Fax Number	:	252-773-0617

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANGELA CLARK
Credential	:
Telephone Number	:	252-222-5877

Provider Enumeration Date	:	03/12/2014
Last Update Date	:	07/22/2014

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