Organization
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PA
Active
Parent organization
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS,PA
Authorized official
ROBERT ALAN WAINER MD (SENIOR PARTNER)
(336) 375-2300
Entity
Organization
Contact information
Practice address
1130 N CHURCH ST, SUITE 100, GREENSBORO, NC 27401-1038
(336) 375-2300
(336) 375-2318
Mailing address
1130 N CHURCH ST, SUITE 100, GREENSBORO, NC 27401-1038
(336) 375-2300
(336) 375-2314
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890206K
—
NC
Enumeration date
05/18/2006
Last updated
03/17/2015
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