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Organization

REGIONAL SURGICAL ASSOCIATES PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PHILLIP P SHADDUCK MD (PRESIDENT OF THE BOARD)
(919) 479-4400
Entity
Organization

Contact information

Practice address
4301 BEN FRANKLIN BLVD, DURHAM, NC 27704
(919) 479-4400
(919) 479-4415
Mailing address
PO BOX 15698, DURHAM, NC 27704
(919) 479-4400
(919) 479-4415

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0261E
BCBSNC
NC
05
890261E
NC
Enumeration date
12/05/2005
Last updated
08/22/2020
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