Organization
TRIANGLE EAST SURGERY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS KOFFER MD (PRESIDENT)
(919) 934-5441
Entity
Organization
Contact information
Practice address
131 E MARKET ST, SMITHFIELD, NC 27577-3915
(919) 934-5441
(919) 934-0152
Mailing address
131 E MARKET ST, SMITHFIELD, NC 27577-3915
(919) 934-5441
(919) 934-0152
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0139L
BCBS
NC
05
—
890139L
—
NC
01
—
DB0235
MEDICARE RAILROAD
NC
Enumeration date
06/01/2006
Last updated
09/05/2013
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