Provider Demographics
NPI:1134395387
Name:BARIATRIC SPECIALISTS OF NORTH CAROLINA, PA
Entity type:Organization
Organization Name:BARIATRIC SPECIALISTS OF NORTH CAROLINA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ENOCHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-234-4468
Mailing Address - Street 1:160 MACGREGOR PINES DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6040
Mailing Address - Country:US
Mailing Address - Phone:919-234-4468
Mailing Address - Fax:919-234-4478
Practice Address - Street 1:160 MACGREGOR PINES DR
Practice Address - Street 2:SUITE 310
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6040
Practice Address - Country:US
Practice Address - Phone:919-234-4468
Practice Address - Fax:919-234-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200027174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty