Individual
ROBERT W SURRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1085 NE GATEWAY CT, SUITE 200, ARDSLEY INTERNAL MEDICINE, CONCORD, NC 28025-2406
(704) 260-8650
(704) 260-8665
Mailing address
1085 NE GATEWAY CT, SUITE 200, ARDSLEY INTERNAL MEDICINE, CONCORD, NC 28025-2406
(704) 260-8650
(704) 260-8665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25087
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110220835
RAILROAD MEDICARE ID
NC
01
—
111011
WELLPATH
NC
01
—
232009
MEDICARE-OTHER
NC
01
—
298677
MAMSI
NC
01
—
31489
MEDCOST
NC
01
—
4324723
AETNA ID
NC
01
—
5246
PARTNERS MEDICARE CH
NC
01
—
566000156
PRACTICE TAX ID
NC
01
—
81014
BCBS ID
NC
05
—
8981014
—
NC
Enumeration date
02/03/2006
Last updated
06/11/2008
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