Provider Demographics
NPI:1952602609
Name:GASTROENTEROLOGY & HEPATOLOGY CONSULTANTS, PA
Entity type:Organization
Organization Name:GASTROENTEROLOGY & HEPATOLOGY CONSULTANTS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-496-2745
Mailing Address - Street 1:10540 LIGON MILL RD.
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-554-6253
Mailing Address - Fax:
Practice Address - Street 1:10540 LIGON MILL RD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-496-3247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-11
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000347261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical