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Organization

METROVIEW VASCULAR AND SURGICAL SPECIALISTS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AUGUSTINE R EZE M.D. (PRESIDENT)
(704) 864-6500
Entity
Organization

Contact information

Practice address
825 MAJESTIC CT STE F, GASTONIA, NC 28054-5190
(704) 864-6500
(704) 864-0104
Mailing address
PO BOX 550490, GASTONIA, NC 28055-0490
(704) 864-6500
(704) 864-0104

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9600205
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1036M
BLUE CROSS
NC
01
16674
PARTNERS MEDICARE
NC
05
5900575
NC
01
7152565
CIGNA
NC
01
NPA752
SC MEDICAID
SC
Enumeration date
09/20/2005
Last updated
02/22/2012
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