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NPI Code Detail

MEDICARE: CAROLINA UROLOGY CLINIC PA

MEDICARE: CAROLINA UROLOGY CLINIC 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
1174400000XSpecialistNC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CG7448OTHERNCRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101601OTHERNCBLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912912494
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA UROLOGY CLINIC PA
Provider Business Mailing Address
First Line : 720 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3706
Country : US
Telephone Number : 910-642-5832
Fax Number : 910-642-8814
Provider Business Practice Location Address
First Line : 720 JEFFERSON ST
Second Line :
City : WHITEVILLE
State : NC
Zip : 28472-3706
Country : US
Telephone Number : 910-642-5832
Fax Number : 910-642-8814
Authorized Official
Title or Position : OWNER
Name : DR. RONALD PETER GLINSKI
Credential : MD, PHD
Telephone Number : 910-642-5832
Provider Enumeration Date : 07/30/2006
Last Update Date : 05/14/2008

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Directions to “CAROLINA UROLOGY CLINIC 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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