Provider Demographics
NPI:1922847599
Name:UROLOGY SPECIALISTS OF THE CAROLINAS
Entity type:Organization
Organization Name:UROLOGY SPECIALISTS OF THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZSIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-372-5180
Mailing Address - Street 1:1085 NORTHEAST GATEWAY COURT NE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025
Mailing Address - Country:US
Mailing Address - Phone:704-707-2200
Mailing Address - Fax:704-707-2203
Practice Address - Street 1:1085 NORTHEAST GATEWAY COURT NE SUITE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025
Practice Address - Country:US
Practice Address - Phone:704-707-2200
Practice Address - Fax:704-707-2203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGY SPECIALISTS OF THE CAROLINAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy