Carlos Jose Anciano Granadillo
Surgeon Cardiothoracic Vascular Surgeon
115 Heart Dr
Greenville
, North Carolina 27834-8982
Carlos Jose Anciano Granadillo
Surgeon Cardiothoracic Vascular Surgeon
115 Heart Dr
Greenville
, North Carolina 27834-8982
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About
Features
Specialties
- Surgeon
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Carlos Jose Anciano Granadillo
- Po Box 751069
- Charlotte, NC
- Zip : 28275-1069
- Phone :
Second Address
- Carlos Jose Anciano Granadillo
- 115 Heart Dr
- Greenville, NC
- Zip : 27834-8982
- Fax : (252) 744-3987
- Phone : (252) 744-4400
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Is Carlos Jose Anciano Granadillo a sole practitioner?
Is Carlos Jose Anciano Granadillo accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 2013-01958 | NC |
| N | 208600000X | Surgeon | 2013-01958 | NC |
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 2013-01958 | NC |
National Provider Identifier
| NPI | 1154563906 |
|---|---|
| Provider Name | Carlos Jose Anciano Granadillo |
| First Address | Charlotte, NC 28275-1069 |
| Second Address | Greenville, NC 27834-8982 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/03/2009 |
| Last Update Date | 25/11/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1154563906 | (05) | NC |
| 184R0 | BCBS NC (01) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.