Provider Demographics
NPI:1073027033
Name:CARY PSYCHIATRY
Entity Type:Organization
Organization Name:CARY PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MIKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-378-9761
Mailing Address - Street 1:1616 EVANS RD STE 204
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-9653
Mailing Address - Country:US
Mailing Address - Phone:919-378-9761
Mailing Address - Fax:919-234-0494
Practice Address - Street 1:1616 EVANS RD STE 204
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-9653
Practice Address - Country:US
Practice Address - Phone:919-378-9761
Practice Address - Fax:919-234-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-043092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932548203OtherPHYSICIAN ASSISTANT