| Carolina Spine And Disc Center | |
|
11618 Us Hwy 70 W Suite 100 Clayton NC 27520-2275 | |
| (919) 373-2000 | |
| (919) 373-2200 |
| Full Name | Carolina Spine And Disc Center |
|---|---|
| Speciality | Family Medicine |
| Location | 11618 Us Hwy 70 W, Clayton, North Carolina |
| Authorized Official Name and Position | Paul Talerico (OWNER) |
| Authorized Official Contact | 9193732000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Spine And Disc Center 11618 Us Hwy 70 W Suite 100 Clayton NC 27520-2275 Ph: (919) 373-2000 | Carolina Spine And Disc Center 11618 Us Hwy 70 W Suite 100 Clayton NC 27520-2275 Ph: (919) 373-2000 |
| NPI Number | 1851719397 |
|---|---|
| Provider Enumeration Date | 04/02/2014 |
| Last Update Date | 10/02/2014 |
| Medicare PECOS PAC ID | 8729208434 |
|---|---|
| Medicare Enrollment ID | O20141003000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851719397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9401064 (North Carolina) | Primary |
| Provider Name | Paul J Talerico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184650277 PECOS PAC ID: 0648258806 Enrollment ID: I20040713000791 |
| Provider Name | Jennifer B Harrison |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588832125 PECOS PAC ID: 6608938071 Enrollment ID: I20081218000268 |
| Provider Name | Anju Dheer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588942049 PECOS PAC ID: 8628335262 Enrollment ID: I20171206002154 |
| Provider Name | Androu Wahba |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942693775 PECOS PAC ID: 6901125434 Enrollment ID: I20180521000337 |
| Provider Name | Tyler C Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255848156 PECOS PAC ID: 4789913369 Enrollment ID: I20190906001512 |
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