Organization
MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA
Active
Organization
MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARION B. PATE III MD (PRESIDENT)
(919) 774-4511
Entity
Organization
Contact information
Practice address
110 DENNIS DR, SANFORD, NC 27330-6343
(919) 774-4511
(919) 774-3196
Mailing address
110 DENNIS DR, SANFORD, NC 27330-6343
(919) 774-4511
(919) 774-3196
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195A
BLUECROSS
NC
05
—
890195A
—
NC
Enumeration date
04/10/2006
Last updated
01/05/2011
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