Organization
SURF PEDIATRICS AND MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIAN THOR LIGE M.D. (PEDIATRICIAN)
(252) 449-5200
Entity
Organization
Contact information
Practice address
5107 N CROATAN HWY STE 101, KITTY HAWK, NC 27949-3989
(252) 255-5321
(252) 565-0534
Mailing address
5107 N CROATAN HWY, KITTY HAWK, NC 27949-3989
(252) 255-5321
(252) 565-0534
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2002-00943
NC
261QP2300X
Primary Care Clinic/Center
200200943
NC
363A00000X
Physician Assistant
0010-01994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5916879
—
NC
Enumeration date
11/28/2007
Last updated
08/05/2020
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