Mid Carolina Surgical Clinic PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

13991 Issued in NC

Legal business name

MID CAROLINA SURGICAL CLINIC PA

Practice address

709B Wicker St
Sanford, NC 27330-4142

Phone

(919) 775-3321

Fax

(919) 774-6974

NPI assigned

May 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael A Gordon, M.D.

Title

President

Phone

(919) 775-3321

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1801001201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709B WICKER ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304142",
            "telephone_number": "919-775-3321",
            "fax_number": "919-774-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709B WICKER ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273304142",
            "telephone_number": "919-775-3321",
            "fax_number": "919-774-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID CAROLINA SURGICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-775-3321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "13991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8936308",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0170C",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle F. Moseley, LPC, PLLC
• Mid Carolina Gastroenterology Associates, PA
• Mid Carolina Gastroenterology Associates, PA
• Mid Carolina Primary Care, PA
• Mid Carolina Radiology Associates PA
• Millenium IV, Inc.
• Millenium IV, Inc.
• Dana Miller, MA
• Gregory Charles Miller, PA-C
• Jonathan Pease Miller, MS, CCA-A

• Specialist in Sanford, NC
• Providers in Sanford, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.