Provider Demographics
NPI:1871539940
Name:CARY SURGICAL SPECIALISTS PC
Entity type:Organization
Organization Name:CARY SURGICAL SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:TYNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-234-4470
Mailing Address - Street 1:160 MACGREGOR PINES DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6040
Mailing Address - Country:US
Mailing Address - Phone:919-234-4470
Mailing Address - Fax:919-234-4475
Practice Address - Street 1:160 MACGREGOR PINES DR
Practice Address - Street 2:SUITE 310
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6040
Practice Address - Country:US
Practice Address - Phone:919-234-4470
Practice Address - Fax:919-234-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty