Provider Demographics
NPI:1922423490
Name:CARY GASTROENTEROLOGY
Entity Type:Organization
Organization Name:CARY GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOLA
Authorized Official - Middle Name:METZ
Authorized Official - Last Name:ALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:919-816-4948
Mailing Address - Street 1:115 KILDAIRE PARK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8144
Mailing Address - Country:US
Mailing Address - Phone:919-816-4948
Mailing Address - Fax:919-233-7685
Practice Address - Street 1:115 KILDAIRE PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8144
Practice Address - Country:US
Practice Address - Phone:919-816-4948
Practice Address - Fax:919-233-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RG0100X
NC9801109261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty