Organization
CENTRAL CAROLINA ENT ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C LELIEVER MD (PRESIDENT)
(919) 774-6829
Entity
Organization
Contact information
Practice address
1915 KM WICKER DRIVE, SANFORD, NC 27330
(919) 774-6829
(919) 775-2327
Mailing address
1915 KM WICKER DRIVE, SANFORD, NC 27330
(919) 774-6829
(919) 775-2327
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3404108
MEDICAID - HEARING AID VENDOR
NC
05
—
890107W
—
NC
01
—
CM5921
PALMETTO GBA-RR MEDICARE
NC
Enumeration date
06/26/2006
Last updated
09/14/2009
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