Provider Demographics
NPI:1427414283
Name:HIGHLAND SURGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:HIGHLAND SURGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:STORTO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:910-491-1188
Mailing Address - Street 1:1565 PURDUE DR
Mailing Address - Street 2:STE 201A
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5536
Mailing Address - Country:US
Mailing Address - Phone:910-491-1188
Mailing Address - Fax:910-491-1531
Practice Address - Street 1:1565 PURDUE DR
Practice Address - Street 2:ST 201A
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5536
Practice Address - Country:US
Practice Address - Phone:910-491-1188
Practice Address - Fax:910-491-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty