ADOLFO RICHARD DESANDRE (NPI# 1710963475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710963475 |
| Entity Type | Individual |
| Full Name | ADOLFO RICHARD DESANDRE |
| Credential | M.D. |
| Practice Address |
584 Hospital Dr Suite A Bolivia NC 28422 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 9107214000 |
| Practice Fax Number | 9107214001 |
| Mailing Telephone | 7043847840 |
| Mailing Fax Number | 7043847830 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 20712 | SC | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 9801631 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NC MEDICAL LICENSE | 9801631 | 01 |
| NC | 8911805 | 05 | |
| SC | SC MEDICAL LICENSE | 20712 | 01 |
| Street Address |
584 HOSPITAL DR SUITE A |
| City | BOLIVIA |
| State | NC |
| Zip Code | 28422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679731822 | Tracey Nicole Mccarthy | Obstetrics & Gynecology | 584 Hospital Dr, Suite B, Bolivia, NC 28422 | 2008-05-23 |
| 1295936722 | Richard Lee Toler | Obstetrics & Gynecology | 584 Hospital Dr, Suite B, Bolivia, NC 28422 | 2007-05-31 |
| 1215047543 | Richard Ralph Scallion | Surgery | 584 Hospital Dr, Suite A, Bolivia, NC 28422 | 2006-08-30 |
| 1760412043 | Edward Woo | Obstetrics & Gynecology | 584 Hospital Dr, Suite B, Bolivia, NC 28422 | 2006-07-03 |
| 1649256850 | Mark Tillotson | Surgery | 584 Hospital Dr, Suite A, Bolivia, NC 28422 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616596 | Riccobene and Associates Xli, Dds, P.a. | Dentist | 211 Midway Commons, Suite 116, Bolivia, NC 28422 | 2020-10-15 |
| 1962029942 | Novant Medical Group. Inc. | Family Medicine | 150 College Rd Ne, Bolivia, NC 28422 | 2020-06-25 |
| 1033730866 | Tamika Jocinda Yushaw | Social Worker | 25 Courthouse Drive Ne, Bolivia, NC 28422 | 2020-05-04 |
| 1821648882 | Daniel Burk | Physician Assistant | 584 Hospital Drive Suite A, Bolivia, NC 28422 | 2019-09-12 |
| 1427452283 | East Carolina University School of Dental Medicine-brunswick | Dentist | 100 Brunswick Medical Center Parkway, Bolivia, NC 28422 | 2014-10-22 |
| 1689080632 | Cecilia Liu | Dentist | 3071 Southport Supply Rd Se, Bolivia, NC 28422 | 2014-07-09 |
| 1922372341 | Lorie L Harding | Physician Assistant | 584 Hospital Dr Ne Unit C, Bolivia, NC 28422 | 2012-03-02 |
| 1902095383 | Cayce Mccall Patterson | Physical Therapist | 35 Referendum Dr, Brunswick County Schools, Bolivia, NC 28422 | 2007-10-22 |
| 1235288622 | Susan Beth Kam | Psychologist | 63 Stamp Act Drive, Bolivia, NC 28422 | 2007-01-09 |
| 1578632477 | Sarah E Oxford | Case Manager/Care Coordinator | 63 Stamp Act Dr, Building M, Bolivia, NC 28422 | 2006-11-06 |
| Find all providers in zip 28422 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104058817 | Matt Benenati | Surgery | 584 Hospital Dr Ne Ste A, Bolivia, NC 28422-9047 | 2009-08-13 |
| 1336229384 | Novant Medical Group Inc | Surgery | 584 Hospital Dr Ne, Suite A, Bolivia, NC 28422-9047 | 2006-10-16 |
| 1215047543 | Richard Ralph Scallion | Surgery | 584 Hospital Dr, Suite A, Bolivia, NC 28422 | 2006-08-30 |
| 1649256850 | Mark Tillotson | Surgery | 584 Hospital Dr, Suite A, Bolivia, NC 28422 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033723531 | Novant Medical Group, Inc. | Surgery | 1450 Matthews Township Pkwy Ste 320, Matthews, NC 28105-2389 | 2020-09-02 |
| 1639701980 | Orthopaedic Surgery Center of Panther Creek LLC | Surgery | 6715 Mccrimmon Pkwy Ste 100, Cary, NC 27519-1916 | 2020-02-05 |
| 1922645571 | Novant Medical Group, Inc. | Surgery | 6324 Fairview Rd Ste 420, Charlotte, NC 28210-3372 | 2019-12-03 |
| 1790335180 | Shihao Lao | Surgery | 2301 Erwin Rd # Dumc2837, Durham, NC 27705-4699 | 2019-09-17 |
| 1336795137 | Novant Medical Group, Inc. | Surgery | 3515 W Market St Ste 310, Greensboro, NC 27403-4438 | 2019-08-16 |
| 1548721046 | Aman Kumar | Surgery | Unc Hospitals Department of Surgery, 101 Manning Drive, Chapel Hill, NC 27514 | 2019-03-27 |
| 1164980546 | Moses Cone Physician Services, Inc. | Surgery | 1041 Kirkpatrick Rd Ste 150, Burlington, NC 27215-8068 | 2019-03-05 |
| 1154806271 | The Cosmetic Concierge, Pllc | Surgery | 325 Arlington Ave Unit B, Charlotte, NC 28203-4574 | 2018-09-25 |
| 1386128601 | Venkateswara Rao Gurram | Surgery | 5075 Winster Dr Apt 202, Winston Salem, NC 27106-2988 | 2018-09-21 |
| 1376022533 | Shawn Thomas Colwell | Surgery | 411 Dogwood Ln, Wilmington, NC 28409-5805 | 2018-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.