Provider Demographics
NPI:1457510414
Name:CAROLINA NEUROLOGY CENTER PLLC
Entity Type:Organization
Organization Name:CAROLINA NEUROLOGY CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-684-1119
Mailing Address - Street 1:50 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 1 A
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-684-1119
Mailing Address - Fax:828-684-1184
Practice Address - Street 1:50 HOSPITAL DR
Practice Address - Street 2:SUITE 1 A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5248
Practice Address - Country:US
Practice Address - Phone:828-684-1119
Practice Address - Fax:828-684-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101210273100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273100000XHospital UnitsEpilepsy Unit