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Organization

SOUTHEASTERN HEART & VASCULAR CENTER PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TODD PITTMAN (EXECUTIVE DIRECTOR)
(336) 273-7900
Entity
Organization

Contact information

Practice address
1816 RICHARDSON DR, REIDSVILLE, NC 27320-5434
(336) 342-4446
(336) 342-7747
Mailing address
1816 RICHARDSON DR, REIDSVILLE, NC 27320-5434
(336) 342-4446
(336) 342-7747

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0129F
BCBS NC
NC
05
790129F
NC
Enumeration date
10/04/2006
Last updated
10/10/2007
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