Provider Demographics
NPI:1801083787
Name:SCOTLAND UROLOGY, P. A.
Entity type:Organization
Organization Name:SCOTLAND UROLOGY, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ORGANIZATION
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONIOS
Authorized Official - Middle Name:ZACHARIAS
Authorized Official - Last Name:KARAMALEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-277-8636
Mailing Address - Street 1:1603 MEDICAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5541
Mailing Address - Country:US
Mailing Address - Phone:910-876-8636
Mailing Address - Fax:910-277-8545
Practice Address - Street 1:1603 MEDICAL DR STE C
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5541
Practice Address - Country:US
Practice Address - Phone:910-876-8636
Practice Address - Fax:910-277-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890137HMedicaid
NCCB8681OtherRAILROAD MEDICARE
NCCB8681OtherRAILROAD MEDICARE
NC890137HMedicaid