Organization
SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANTHOSH AUGUSTINE MD (PRESIDENT)
(910) 739-0770
Entity
Organization
Contact information
Practice address
101 W 27TH ST, LUMBERTON, NC 28358-3014
(910) 739-0770
(910) 739-4102
Mailing address
101 W 27TH ST, LUMBERTON, NC 28358-3014
(910) 739-0770
(910) 739-4102
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
138988
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02BBD
BCBS
NC
05
—
3409832
—
NC
Enumeration date
12/29/2006
Last updated
01/24/2017
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