# GENESISCARE USA OF NORTH CAROLINA, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Genesiscare Surgical Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477144004
- **Authorized official:** TIMOTHY D. SHAFMAN MD (PRESIDENT)
- **Authorized official phone:** (401) 456-2690

## Contact information

- **Practice address:** 20 MEDICAL PARK DR, ASHEVILLE, NC 28803-2493
- **Practice address phone:** (239) 931-7342
- **Practice address fax:** (239) 931-7385
- **Mailing address:** 1419 SE 8TH TER STE 200, CAPE CORAL, FL 33990-3213
- **Mailing address phone:** (239) 931-7342
- **Mailing address fax:** (239) 931-7385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086X0206X | Surgical Oncology Physician | — | NULL | — |
| 2086X0206X | Surgical Oncology Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/27/2021
- **Last updated:** 09/25/2023