Provider Demographics
NPI:1629005517
Name:CATAWBA VALLEY NEUROSURGICAL & SPINE SERVICES PLLC
Entity Type:Organization
Organization Name:CATAWBA VALLEY NEUROSURGICAL & SPINE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCCLOSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-327-6433
Mailing Address - Street 1:915 TATE BLVD SE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-4042
Mailing Address - Country:US
Mailing Address - Phone:828-327-6499
Mailing Address - Fax:828-327-9902
Practice Address - Street 1:915 TATE BLVD SE
Practice Address - Street 2:SUITE 120
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-327-6499
Practice Address - Fax:828-327-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7902368Medicaid
NC7902368Medicaid