Provider Demographics
NPI:1902983828
Name:ADVANCED SURGICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:ADVANCED SURGICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-851-9193
Mailing Address - Street 1:530 NEW WAVERLY PL
Mailing Address - Street 2:STE 304
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7414
Mailing Address - Country:US
Mailing Address - Phone:919-851-9193
Mailing Address - Fax:919-851-9223
Practice Address - Street 1:530 NEW WAVERLY PL
Practice Address - Street 2:STE 304
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7414
Practice Address - Country:US
Practice Address - Phone:919-851-9193
Practice Address - Fax:919-851-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC016W6OtherBCBS
NC5900017Medicaid
NC5900017Medicaid
NC=========OtherUNITED HEALTHCARE
NC=========OtherMEDCOST
NC=========OtherAETNA
NC016W6OtherBCBS
NC=========OtherWELLPATH