Bovard Bariatric Center PA
Surgery in Raleigh, NC. Organization (NPI-2).
NPI number1265619787
StatusActive
Last updated in NPPESOct 9, 2012
Details
- NPI
- 1265619787
- Entity type
- Organization (NPI-2)
- Legal business name
- Bovard Bariatric Center PA
- Organization subpart
- No
- Enumeration date
- Jan 28, 2008
- Last updated
- Oct 9, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 2008-00006 | NC | Yes |
Other names
- Triangle Weight Loss Surgery (Doing Business As)
Practice location
11200 Governor Manly WaySuite 200
Raleigh, NC 27614-8599
Phone 919-340-2263 · Fax 919-554-3771
Mailing address
11200 Governor Manly WaySuite 200
Raleigh, NC 27614-8599
Phone 919-340-2263 · Fax 919-554-3771
Authorized official
Scott Bovard
Owner
9193402263
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