Organization
FAYETTEVILLE ANESTHESIA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVERETT L. PERRY M.D. (PRESIDENT)
(910) 480-0727
Entity
Organization
Contact information
Practice address
1781 METROMEDICAL DR, FAYETTEVILLE, NC 28304-3424
(910) 609-6440
(910) 609-5365
Mailing address
135 DUNDEE RD., FAYETTEVILLE, NC 28303
(910) 480-0727
(910) 323-4142
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000221
—
NC
05
—
890137T
—
NC
01
—
CD2456
MEDICARE GROUP #
NC
Enumeration date
02/12/2007
Last updated
02/02/2023
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