Organization
HALIFAX ORTHOPAEDIC & HAND SURGERY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GANESH BISSRAM MD (PRESIDENT)
(252) 535-3091
Entity
Organization
Contact information
Practice address
130 CARDINAL DRIVE, ROANOKE RAPIDS, NC 27870
(252) 535-3091
(252) 535-3092
Mailing address
130 CARDINAL DRIVE, ROANOKE RAPIDS, NC 27870
(252) 535-3091
(252) 535-3092
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
24890
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901714
—
NC
Enumeration date
04/11/2007
Last updated
09/28/2010
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