Provider Demographics
NPI:1790817963
Name:CARY PEDIATRIC CENTER PA
Entity Type:Organization
Organization Name:CARY PEDIATRIC CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE PERSONNEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-467-1057
Mailing Address - Street 1:1001 CRESCENT GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8101
Mailing Address - Country:US
Mailing Address - Phone:919-467-3211
Mailing Address - Fax:919-467-5315
Practice Address - Street 1:1001 CRESCENT GREEN DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8101
Practice Address - Country:US
Practice Address - Phone:919-467-3211
Practice Address - Fax:919-467-5315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty