Organization
CAROLINA VASCULAR SURGERY AND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E FOGARTIE JR. MD (TREASURER)
(919) 235-3400
Entity
Organization
Contact information
Practice address
3713 BENSON DRIVE, SUITE 201, CAROLINA VASCULAR SURGERY & DIAGNOSTICS, PA, RALEIGH, NC 27609-7372
(919) 235-3400
(919) 235-3401
Mailing address
3713 BENSON DRIVE, SUITE 201, RALEIGH, NC 27609-7372
(919) 235-3400
(919) 235-3401
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014EK
BLUE CROSS BLUE SHIELD
NC
01
—
464895
ANTHEM
NC
05
—
89014EK
—
NC
01
—
DA1192
MEDICARE RAILROAD
NC
01
—
DA1192
RAILROAD MEDIC
—
01
—
IP096
PARTNERS MEDICARE
NC
Enumeration date
05/24/2006
Last updated
02/05/2015
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