Provider Demographics
NPI:1518122167
Name:NORTH CAROLINA SURGICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:NORTH CAROLINA SURGICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-496-1050
Mailing Address - Street 1:1501 N BICKETT BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2178
Mailing Address - Country:US
Mailing Address - Phone:919-496-1050
Mailing Address - Fax:
Practice Address - Street 1:1501 N BICKETT BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2178
Practice Address - Country:US
Practice Address - Phone:919-496-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-23
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912860Medicaid
NC2289669AMedicare PIN