Provider Demographics
NPI:1902868805
Name:CARDINAL MEDICAL SPECIALISTS, PA
Entity Type:Organization
Organization Name:CARDINAL MEDICAL SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:910-892-4208
Mailing Address - Street 1:PO BOX 700
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28335-0700
Mailing Address - Country:US
Mailing Address - Phone:910-892-4208
Mailing Address - Fax:910-892-5182
Practice Address - Street 1:861 TILGHMAN DR
Practice Address - Street 2:SUITE 105
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5994
Practice Address - Country:US
Practice Address - Phone:910-892-4208
Practice Address - Fax:910-892-5182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801126207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG86292Medicare UPIN