Provider Demographics
NPI:1710057443
Name:PINEHURST OBGYN ASSOCIATES PA
Entity Type:Organization
Organization Name:PINEHURST OBGYN ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:V
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-295-7188
Mailing Address - Street 1:285 OLMSTED BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9021
Mailing Address - Country:US
Mailing Address - Phone:910-295-7188
Mailing Address - Fax:
Practice Address - Street 1:285 OLMSTED BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9021
Practice Address - Country:US
Practice Address - Phone:910-295-7881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2168283DMedicare ID - Type Unspecified
NCF19182Medicare UPIN