Active NPI 1689871683 Individual Practitioner Male Practitioner

Dr. David Wayne Grantham , MD

Surgery • Pinehurst, NC

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. David Grantham, MD is a certified Surgery practicing in Pinehurst, NC. With approximately 24 years of clinical experience since graduating from University Of North Carolina At Chapel Hill School Of Medicine in 2002, Dr. Grantham delivers high-quality medical care to the local community at 5 FIRST VILLAGE DRIVE.

Dr. Grantham maintains professional affiliations with Pinehurst Surgical Clinic Pa, Mcpc-9 Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, routine electrocardiogram (ecg) using at least 12 leads with tracing. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5 First Village Drive

Pinehurst, NC 283742000

Telephone 9102956831

Fax 9102950244

Associated Practice Facility / Clinic

🏢 Pinehurst Surgical Clinic Pa Facility NPI 1962434324

Medicare Profile & Education

Medical School

University Of North Carolina At Chapel Hill School Of Medicine

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Pinehurst, NC

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

24 Yrs -1.2 yrs vs City Avg

City Avg: 25.2 Yrs

State Avg: 24.9 Yrs

Regional Practice Density

12 Specialists

Practicing in Pinehurst, NC (1222 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Grantham (24 Years) 24 Yrs

Pinehurst Specialty Average (25.2 Years) 25.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	133	103	$360.71	$85.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$662.06	$157.55
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	61	61	$24.00	$5.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	52	48	$509.87	$118.56
36415 Insertion of needle into vein for collection of blood sample	46	42	$25.00	$8.65
80053 Blood test, comprehensive group of blood chemicals	41	40	$74.00	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	40	39	$37.00	$7.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$443.54	$104.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	25	24	$633.80	$163.45
49650 Repair of groin hernia using an endoscope	24	24	$1826.63	$426.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	18	$223.96	$53.16
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	20	19	$280.00	$74.37
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	18	18	$2750.00	$661.32
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	18	18	$52.00	$12.34
77067 Screening mammography	14	14	$348.00	$84.22
77063 Screening digital tomography of both breasts	14	14	$95.00	$21.91
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	13	13	$89.00	$17.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	133	109	$251.16	$86.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	61	53	$367.92	$123.19
36415 Insertion of needle into vein for collection of blood sample	57	54	$23.11	$8.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	55	55	$540.58	$157.61
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	49	48	$37.00	$7.61
80053 Blood test, comprehensive group of blood chemicals	48	47	$77.67	$10.35
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	44	43	$32.73	$5.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$332.96	$107.74
49650 Repair of groin hernia using an endoscope	22	22	$1981.36	$481.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	18	$142.20	$54.24
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	19	19	$92.16	$22.66
77067 Screening mammography	15	15	$364.00	$81.39
77063 Screening digital tomography of both breasts	15	15	$95.00	$21.18
77066 Diagnostic mammography of both breasts	14	14	$438.50	$105.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	175	132	$140.38	$88.23
36415 Insertion of needle into vein for collection of blood sample	114	109	$21.00	$2.97
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	108	104	$37.00	$7.68
80053 Blood test, comprehensive group of blood chemicals	107	104	$82.00	$10.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	87	87	$312.83	$162.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	75	$206.76	$122.98
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	84	84	$48.00	$5.76
49650 Repair of groin hernia using an endoscope	46	46	$2000.87	$473.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$206.30	$109.53
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	38	32	$165.05	$69.30
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	26	26	$402.46	$193.31
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	24	20	$95.00	$22.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	19	$85.00	$55.06
77066 Diagnostic mammography of both breasts	15	14	$457.00	$107.30
77067 Screening mammography	14	14	$378.00	$82.52
77063 Screening digital tomography of both breasts	14	14	$95.00	$20.94
76705 Limited ultrasound scan of abdomen	13	13	$300.00	$57.74
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	13	13	$70.62	$13.20
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	13	13	$2837.00	$657.54
49652 Repair of hernia using an endoscope	11	11	$2041.00	$704.14
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$267.27	$131.52
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$746.82	$65.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	200	152	$140.00	$89.25
36415 Insertion of needle into vein for collection of blood sample	108	100	$21.00	$3.00
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	91	85	$37.00	$7.77
80053 Blood test, comprehensive group of blood chemicals	86	82	$82.00	$10.56
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	85	85	$48.00	$6.19
71046 X-ray of chest, 2 views	79	78	$73.54	$22.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	77	68	$205.00	$125.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	72	72	$205.00	$109.95
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	72	72	$310.00	$161.65
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	44	41	$165.02	$70.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	41	34	$85.00	$55.08
49650 Repair of groin hernia using an endoscope	36	36	$2340.00	$516.39
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	23	23	$69.65	$14.07
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	23	23	$2837.00	$716.39
45380 Biopsy of large bowel using an endoscope	20	20	$1252.00	$134.91
77065 Diagnostic mammography of 1 breast	20	18	$358.00	$83.73
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	18	$375.67	$175.27
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	17	15	$95.00	$23.97
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	14	$949.00	$100.83
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$145.00	$71.40
77066 Diagnostic mammography of both breasts	12	12	$457.00	$109.62
77067 Screening mammography	11	11	$378.00	$87.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	216	154	$140.00	$71.40
36415 Insertion of needle into vein for collection of blood sample	137	119	$21.00	$2.97
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	122	106	$37.00	$7.68
80053 Blood test, comprehensive group of blood chemicals	118	106	$82.00	$10.46
71046 X-ray of chest, 2 views	102	98	$73.42	$20.68
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	92	92	$48.00	$8.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$310.00	$161.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	68	59	$205.00	$106.57
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	67	67	$205.00	$104.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	52	$85.00	$43.86
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	51	45	$165.08	$71.06
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	29	29	$374.79	$201.12
49650 Repair of groin hernia using an endoscope	29	29	$2044.14	$446.02
77066 Diagnostic mammography of both breasts	20	20	$457.00	$113.05
77065 Diagnostic mammography of 1 breast	20	20	$358.00	$88.72
99231 Follow-up hospital inpatient care per day, typically 15 minutes	17	15	$129.06	$37.31
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	17	17	$2837.00	$719.18
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	17	17	$72.00	$18.05
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	15	14	$949.00	$116.83
43282 Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope	12	12	$4812.00	$1748.75
45380 Biopsy of large bowel using an endoscope	12	12	$1252.00	$155.23
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$747.00	$61.81
74177 Ct scan of abdomen and pelvis with contrast	11	11	$966.00	$224.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	254	186	$117.07	$71.77
36415 Insertion of needle into vein for collection of blood sample	136	125	$21.00	$2.94
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	123	115	$37.00	$8.40
80053 Blood test, comprehensive group of blood chemicals	122	113	$82.00	$11.42
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	102	101	$48.00	$7.96
71046 X-ray of chest, 2 views	101	100	$73.00	$19.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	75	75	$172.33	$104.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	73	68	$180.22	$105.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	72	72	$280.29	$159.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	71	64	$75.99	$42.87
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	45	43	$164.67	$71.29
49650 Repair of groin hernia using an endoscope	33	33	$2032.73	$469.79
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	33	33	$376.82	$198.19
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	30	30	$949.00	$134.31
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	23	23	$2837.00	$670.81
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	22	22	$72.00	$18.07
77065 Diagnostic mammography of 1 breast	21	21	$358.00	$87.40
45380 Biopsy of large bowel using an endoscope	20	20	$1252.00	$71.73
99231 Follow-up hospital inpatient care per day, typically 15 minutes	17	16	$131.71	$38.56
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	15	14	$747.00	$65.48
77066 Diagnostic mammography of both breasts	15	15	$457.00	$111.84
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	14	14	$1504.00	$250.77
76705 Limited ultrasound scan of abdomen	14	13	$300.00	$57.90
43282 Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope	14	13	$4812.00	$1678.75
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$117.73	$71.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	241	176	$115.00	$69.63
36415 Insertion of needle into vein for collection of blood sample	154	129	$21.00	$2.94
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	145	126	$37.00	$9.40
80053 Blood test, comprehensive group of blood chemicals	136	120	$82.00	$12.78
71046 X-ray of chest, 2 views	103	101	$73.42	$18.03
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	102	100	$48.00	$7.77
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	102	102	$170.00	$101.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	66	57	$178.00	$103.16
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	64	52	$75.00	$41.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	61	61	$279.00	$154.91
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	48	43	$164.83	$67.56
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	41	40	$382.46	$196.31
49650 Repair of groin hernia using an endoscope	30	30	$1768.00	$419.75
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	23	23	$72.00	$17.78
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	23	23	$2837.00	$675.29
77065 Diagnostic mammography of 1 breast	22	19	$358.00	$88.19
45380 Biopsy of large bowel using an endoscope	21	21	$1252.00	$138.52
99231 Follow-up hospital inpatient care per day, typically 15 minutes	20	18	$125.75	$37.93
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	19	19	$949.00	$127.13
76705 Limited ultrasound scan of abdomen	14	13	$300.00	$58.36
77066 Diagnostic mammography of both breasts	14	13	$457.00	$112.44
74177 Ct scan of abdomen and pelvis with contrast	12	11	$966.00	$205.16
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$115.00	$71.86
80061 Blood test, lipids (cholesterol and triglycerides)	11	11	$92.00	$16.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	237	166	$115.00	$69.45
36415 Insertion of needle into vein for collection of blood sample	180	147	$21.00	$2.92
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	166	136	$37.00	$10.26
80053 Blood test, comprehensive group of blood chemicals	157	131	$82.00	$11.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	120	120	$170.00	$101.89
71020 X-ray of chest, 2 views, front and side	105	105	$78.55	$15.65
93005 Routine electrocardiogram (ecg) using at least 12 leads with tracing	99	98	$48.00	$7.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	88	77	$75.00	$40.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	71	64	$178.00	$97.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$279.00	$156.82
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	47	43	$164.32	$69.80
99231 Follow-up hospital inpatient care per day, typically 15 minutes	32	31	$131.38	$37.86
99202 New patient office or other outpatient visit, typically 20 minutes	29	29	$115.00	$71.15
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	28	28	$371.14	$188.55
G0206 Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral	26	26	$376.00	$87.45
49650 Repair of groin hernia using an endoscope	25	25	$1684.80	$408.43
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	19	19	$2837.00	$687.91
G0204 Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral	18	18	$479.00	$111.52
74300 Review by radiologist of bile and/or pancreatic duct image during surgery	18	18	$71.00	$17.74
45380 Biopsy of large bowel using an endoscope	15	15	$1252.00	$63.66
76705 Limited ultrasound scan of abdomen	13	11	$300.00	$53.49
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	13	12	$949.00	$127.13
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$747.00	$55.80
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	11	11	$1504.00	$253.20
80061 Blood test, lipids (cholesterol and triglycerides)	11	11	$92.00	$11.73

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NC 2007-01020

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

3810009398 (WV)

Medicaid State Provider ID

5907193 (NC)

Medicaid State Provider ID

1689871683 (VA)

Medicaid State Provider ID

Q20007 (SC)

Commercial Insurance / Payer ID Aetna

7263977

Commercial Insurance / Payer ID Bcbs

145NY

Commercial Insurance / Payer ID Medcost

199308

Commercial Insurance / Payer ID Partners

810125

Hospital & Practice Group Affiliations

Mcpc-9 Llc

809 S Long Dr, Rockingham, NC 283794377

Phone: 9104174096

Pinehurst Surgical Clinic Pa

5 1st Village Dr, Pinehurst, NC 283749495

Phone: 9102956831

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Toni Anne Washington , MD

Anesthesiology

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Doctor of Medicine (M.D.)

Dr. Olufunsho Adamolekun , DO

Surgery - Vascular Surgery

NPI 1013210459

Doctor of Osteopathic Medicine (D.O.)

Chad Cole , PA

Physician Assistant

NPI 1013975481

Physician Assistant

Stephen Bush , PA-C

Physician Assistant

NPI 1033532791

Physician Assistant (Certified)

James Nichols , PA-C

Physician Assistant - Surgical

NPI 1043241763

Physician Assistant (Certified)

Dr. Reid Vegeler , MD

Surgery

NPI 1043471121

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

📍

Updated Business Mailing Address September 10, 2018

Registered at 5 FIRSTVILLAGE DRIVE, PO BOX 2000, PINEHURST, NC 28374 (Tel: 9102956831)

✅

NPI Profile Active October 17, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location October 17, 2012

Registered at 5 FIRST VILLAGE DRIVE, PINEHURST, NC 283742000 (Tel: 9102956831)

📍

Updated Business Mailing Address October 17, 2012

Registered at 5 FIRST VILLAGE DRIVE, PINEHURST, NC 283742000 (Tel: 9102956831)

👤

Provider Name / Credentials Updated October 17, 2012

Recorded as DAVID GRANTHAM, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2012

Surgery (License #2007-01020 in NC)

🟢

Initial NPI Registration & Enumeration July 02, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689871683

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 02, 2007

Last Update: September 10, 2018

Sole Proprietor: No

Update or Correct Profile

Mailing Address

5 Firstvillage Drive, Po Box 2000

Pinehurst, NC 28374

Phone: 9102956831

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

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