Provider Demographics
NPI:1053399394
Name:ARTHRITIS RHEUMATOLOGY & OSTEOPOROSIS CENTER OF NC, PA
Entity type:Organization
Organization Name:ARTHRITIS RHEUMATOLOGY & OSTEOPOROSIS CENTER OF NC, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WIENER
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:919-841-9002
Mailing Address - Street 1:5711 SIX FORKS RD
Mailing Address - Street 2:207
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3888
Mailing Address - Country:US
Mailing Address - Phone:919-841-9002
Mailing Address - Fax:919-841-9954
Practice Address - Street 1:5711 SIX FORKS RD
Practice Address - Street 2:207
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3888
Practice Address - Country:US
Practice Address - Phone:919-841-9002
Practice Address - Fax:919-841-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87310207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0276YOtherBLUE CROSS BLUE SHIELD
NC590276YMedicaid