Organization
SHELBY ANESTHESIOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILSON FARRIS SURRATT MD (PRESIDENT)
(704) 482-5716
Entity
Organization
Contact information
Practice address
201 E GROVER ST, SHELBY, NC 28150-3917
(704) 487-3000
(706) 737-2272
Mailing address
PO BOX 890561, CHARLOTTE, NC 28289-0561
(800) 919-1190
(706) 737-2272
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NC
367500000X
Certified Registered Nurse Anesthetist
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01418
BLUE CROSS
NC
05
—
7901418
—
NC
Enumeration date
05/13/2006
Last updated
07/21/2022
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