# HANOVER MEDICAL SPECIALISTS PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HANOVER MEDICAL SPECIALITS - ENDOSCOPY CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871755603
- **Legal business name:** HANOVER MEDICAL SPECIALITS - ENDOSCOPY CENTER
- **Authorized official:** BARBARA L MAISENHELDER (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (910) 815-0889

## Contact information

- **Practice address:** 1515 DOCTORS CIR, HANOVER MEDICAL SPECIALISTS PA, WILMINGTON, NC 28401-7403
- **Practice address phone:** (910) 763-1219
- **Practice address fax:** (910) 343-9702
- **Mailing address:** 1515 DOCTORS CIR, HANOVER MEDICAL SPECIALISTS PA, WILMINGTON, NC 28401-7403
- **Mailing address phone:** (910) 763-1219
- **Mailing address fax:** (910) 343-9702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 40135 | NC | Yes |

## Other

- **Enumeration date:** 07/02/2008
- **Last updated:** 07/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 34C0001151 | ASC IDENTIFICATION NUMBER | NC |