Provider Demographics
NPI:1760577274
Name:CARY HEALTHCARE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CARY HEALTHCARE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-233-6000
Mailing Address - Street 1:222 ASHVILLE AVENUE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6669
Mailing Address - Country:US
Mailing Address - Phone:919-233-6000
Mailing Address - Fax:
Practice Address - Street 1:222 ASHVILLE AVENUE
Practice Address - Street 2:SUITE 10
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6669
Practice Address - Country:US
Practice Address - Phone:919-233-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011YXMedicaid