Provider Demographics
NPI:1831165802
Name:CAPE FEAR CARDIOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:CAPE FEAR CARDIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOR
Authorized Official - Middle Name:E
Authorized Official - Last Name:KLANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-485-6470
Mailing Address - Street 1:3634 CAPE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304
Mailing Address - Country:US
Mailing Address - Phone:910-485-6470
Mailing Address - Fax:910-485-8198
Practice Address - Street 1:3634 CAPE CENTER DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304
Practice Address - Country:US
Practice Address - Phone:910-485-6470
Practice Address - Fax:910-485-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890141GMedicaid
0141GOtherBCBSNC
NC230723Medicare PIN