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COASTAL VASCULAR INSTITUTE PA NPI 1578656773


NPI Information

NPI: 1578656773
Provider Name: COASTAL VASCULAR INSTITUTE, PA

Former Legal Business Name: COASTAL CAROLINA SURGICAL ASSOCIATES, PA

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
1411 PHYSICIANS DRIVE
WILMINGTON, NC
ZIP 28401
Phone: (910) 343-0811
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COASTAL VASCULAR INSTITUTE, PA is a vascular surgery surgery in Wilmington, NC. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. COASTAL VASCULAR INSTITUTE, PA NPI is 1578656773. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Coastal Carolina Surgical Associates, Pa.

The provider's business location address is:

1411 PHYSICIANS DRIVE
WILMINGTON, NC
ZIP 28401-338
Phone: (910) 343-0811
Fax: (910) 343-5719

The provider's authorized official is Kara Florence Marcussen .
The authorized official title is Ceo and has the following contact phone number (910) 343-0811.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 4/25/2023.


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
1208600000XSurgeryCERTIFICATE # 40958NORTH CAROLINANo
2208600000XSurgery40958NORTH CAROLINANo
32086S0129XSurgeryVascular Surgery40958NORTH CAROLINANo
42086S0129XSurgeryVascular SurgeryCERTIFICATE # 40958NORTH CAROLINAYes

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
179-0271CMEDICAIDNORTH CAROLINA
2142384OTHERNORTH CAROLINAGRP UNITED HEALTHCARE #
30271COTHERNORTH CAROLINABCBS OF NC GROUP #
40271COTHERNORTH CAROLINABCBS OF NC
5CB0557OTHERNORTH CAROLINARAILROAD MEDICARE GROUP #

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: 4/28/2024

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