Provider Demographics
NPI:1639358369
Name:ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE PC
Entity Type:Organization
Organization Name:ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:THORP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-338-3993
Mailing Address - Street 1:1134 N ROAD ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3365
Mailing Address - Country:US
Mailing Address - Phone:252-338-3993
Mailing Address - Fax:252-338-2829
Practice Address - Street 1:1134 N ROAD ST
Practice Address - Street 2:SUITE 7
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3365
Practice Address - Country:US
Practice Address - Phone:252-338-3993
Practice Address - Fax:252-338-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty