Organization
OWEN DRIVE SURGICAL CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBI CHAUDHURI MD (PRESIDENT)
(910) 484-0101
Entity
Organization
Contact information
Practice address
1617 OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 484-0101
(910) 484-2563
Mailing address
PO BOX 1615, ETOWAH, NC 28729-1615
(910) 484-0101
(910) 484-2563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255A
BCBS
NC
05
—
89-0255A
—
NC
Enumeration date
09/16/2006
Last updated
10/07/2009
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