SOUTHEAST RADIATION ONCOLOGY GROUP, P.A.; NPI #1568400109

Contact Information

SOUTHEAST RADIATION ONCOLOGY GROUP, P.A.

200 QUEENS RD
SUITE 400
CHARLOTTE, NC 28204-3252

Phone: 704-333-7376
Fax: 704-333-3397
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Radiation Oncology	2085R0001X	92	Physician/Radiation Oncology

Indicates primary specialty

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NPI Profile & details for SOUTHEAST RADIATION ONCOLOGY GROUP, P.A.

NPI # 1568400109

LBN Legal business name SOUTHEAST RADIATION ONCOLOGY GROUP, P.A.

Authorized official PAUL WILLIAMS - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/04/2006

Last updated 01/26/2010 - About 16 years ago

Identifiers

NC	Medicaid	8901351
SC	Medicaid	NPA534
	Other	131977	UNITED HEALTHCARE
NC	Other	01351	BLUE CROSS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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