Provider Demographics
NPI:1144767260
Name:ASSOCIATED UROLOGISTS OF NORTH CAROLINA, PA
Entity Type:Organization
Organization Name:ASSOCIATED UROLOGISTS OF NORTH CAROLINA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-390-7400
Mailing Address - Street 1:3821 ED DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8038
Mailing Address - Country:US
Mailing Address - Phone:919-758-8677
Mailing Address - Fax:919-758-8723
Practice Address - Street 1:10208 CERNY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7884
Practice Address - Country:US
Practice Address - Phone:919-758-8677
Practice Address - Fax:919-758-8723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty