Organization
SANDHILLS HEART SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT FIETSAM JR. MD (PRESIDENT)
(910) 323-9922
Entity
Organization
Contact information
Practice address
3419A MELROSE RD, FAYETTEVILLE, NC 28304-1608
(910) 323-9922
(910) 323-9501
Mailing address
PO BOX 3193, DURHAM, NC 27715-3193
(919) 544-6318
(919) 544-6336
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017RP
BCBS-NC GROUP
NC
05
—
5902973
—
NC
Enumeration date
06/04/2006
Last updated
08/22/2020
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