Organization
CAROLINA GASTROENTEROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINOD CHITA VALLABH MD (PRESIDENT)
(919) 854-2500
Entity
Organization
Contact information
Practice address
570 NEW WAVERLY PL, SUITE 140, CARY, NC 27518
(919) 854-2500
(919) 854-2510
Mailing address
PO BOX 2016, CARY, NC 27512-2016
(919) 854-2500
(919) 854-2510
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017NU
BLUE CROSS
NC
05
—
7985119
—
NC
01
—
85119
BCBS FEDRAL
NC
Enumeration date
02/08/2007
Last updated
04/23/2008
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