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Organization

HANOVER MEDICAL SPECIALISTS PA

Active
Parent organization
HANOVER MEDICAL SPECIALITS - ENDOSCOPY CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
HANOVER MEDICAL SPECIALITS - ENDOSCOPY CENTER
Authorized official
BARBARA L MAISENHELDER (CHIEF EXECUTIVE OFFICER)
(910) 815-0889
Entity
Organization

Contact information

Practice address
1515 DOCTORS CIR, HANOVER MEDICAL SPECIALISTS PA, WILMINGTON, NC 28401-7403
(910) 763-1219
(910) 343-9702
Mailing address
1515 DOCTORS CIR, HANOVER MEDICAL SPECIALISTS PA, WILMINGTON, NC 28401-7403
(910) 763-1219
(910) 343-9702

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
40135
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34C0001151
ASC IDENTIFICATION NUMBER
NC
Enumeration date
07/02/2008
Last updated
07/02/2008
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