Provider Demographics
NPI:1427397991
Name:CARY DIGESTIVE DISEASES, PLLC
Entity Type:Organization
Organization Name:CARY DIGESTIVE DISEASES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:PRITCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-854-5630
Mailing Address - Street 1:251 KEISLER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7091
Mailing Address - Country:US
Mailing Address - Phone:919-854-5630
Mailing Address - Fax:919-854-5632
Practice Address - Street 1:251 KEISLER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7091
Practice Address - Country:US
Practice Address - Phone:919-854-5630
Practice Address - Fax:919-854-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32559174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2152958AMedicare UPIN