Organization
CAROLINA VASCULAR INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE R ROULHAC MD (PRESIDENT)
(910) 822-6587
Entity
Organization
Contact information
Practice address
1251 OLIVER ST, FAYETTEVILLE, NC 28304-4450
(910) 822-6587
(910) 426-6587
Mailing address
PO BOX 2493, DURHAM, NC 27715-2493
(919) 544-6318
(919) 544-6336
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8973468
—
NC
01
—
DB8445
RAILROAD MEDICARE
NC
Enumeration date
06/09/2006
Last updated
03/27/2008
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