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SOUTHEAST RADIATION ONCOLOGY GROUP P.A. NPI 1568400109


NPI Information

NPI: 1568400109
Provider Name: SOUTHEAST RADIATION ONCOLOGY GROUP, P.A.
Classification: Radiology - 2085R0001X
Entity Type: Organization

Specialization: Radiation Oncology

Address:
200 QUEENS RD
SUITE 400
CHARLOTTE, NC
ZIP 28204
Phone: (704) 333-7376
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SOUTHEAST RADIATION ONCOLOGY GROUP, P.A. is a radiation oncology radiology in Charlotte, NC. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. SOUTHEAST RADIATION ONCOLOGY GROUP, P.A. NPI is 1568400109. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

200 QUEENS RD
SUITE 400
CHARLOTTE, NC
ZIP 28204-252
Phone: (704) 333-7376
Fax: (704) 333-3397

The provider's authorized official is Paul A Williams .
The authorized official title is Administrator and has the following contact phone number (704) 333-7376.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 1/26/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0001XRadiologyRadiation OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1230288MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
2NPA534MEDICAIDSOUTH CAROLINA
301351OTHERNORTH CAROLINABLUE CROSS
4131977OTHERUNITED HEALTHCARE
5CA0264MEDICARE ID-TYPE UNSPECIFIEDSOUTH CAROLINARAILROAD MEDICARE
68901351MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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