Provider Demographics
NPI:1043494784
Name:ORTHOPAEDIC TRAUMA SPECIALISTS PC
Entity type:Organization
Organization Name:ORTHOPAEDIC TRAUMA SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-299-0099
Mailing Address - Street 1:1321 NEW GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2722
Mailing Address - Country:US
Mailing Address - Phone:336-299-0099
Mailing Address - Fax:336-299-0080
Practice Address - Street 1:1321 NEW GARDEN RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2722
Practice Address - Country:US
Practice Address - Phone:336-299-0099
Practice Address - Fax:336-299-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200501321207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2050548BMedicare PIN
NCI49269Medicare UPIN
NC6160800001Medicare NSC