Provider Demographics
NPI:1851989669
Name:ASSOCIATED UROLOGISTS OF NORTH CAROLINA, PA
Entity Type:Organization
Organization Name:ASSOCIATED UROLOGISTS OF NORTH CAROLINA, PA
Other - Org Name:AUNC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KISSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURVIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-863-9441
Mailing Address - Street 1:105 SW CARY PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5600
Mailing Address - Country:US
Mailing Address - Phone:919-863-9441
Mailing Address - Fax:919-863-9442
Practice Address - Street 1:781 AVENT FERRY RD STE 204
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-467-3203
Practice Address - Fax:919-460-8915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty