Organization
MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARION BUTLER PATE III M.D. (PRESIDENT)
(919) 774-4511
Entity
Organization
Contact information
Practice address
110 DENNIS DR, SANFORD, NC 27330-6343
(919) 774-4511
(919) 774-3196
Mailing address
110 DENNIS DR, SANFORD, NC 27330-6343
(919) 774-4511
(919) 774-3196
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
AS0094
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34C0001125
ASC IDENTIFICATION NUMBER
NC
Enumeration date
06/24/2008
Last updated
09/29/2014
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