Provider Demographics
NPI:1174817993
Name:AMERICAN ANESTHESIOLOGY OF NORTH CAROLINA, PLLC
Entity Type:Organization
Organization Name:AMERICAN ANESTHESIOLOGY OF NORTH CAROLINA, PLLC
Other - Org Name:SOUTHEAST PAIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:754-247-4124
Mailing Address - Street 1:1305 WALT WHITMAN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4300
Mailing Address - Country:US
Mailing Address - Phone:516-208-4250
Mailing Address - Fax:704-248-5537
Practice Address - Street 1:355 VENUS ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4025
Practice Address - Country:US
Practice Address - Phone:980-993-7230
Practice Address - Fax:704-291-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918189Medicaid
SCQPB692Medicaid
SCDS7032OtherRAILROAD-MEDICARE
NC025AGOtherBCBSNC
NCCB1276OtherRAILROAD-MEDICARE
NCCB1276OtherRAILROAD-MEDICARE
SCQPB692Medicaid