| Growing Child Pediatrics, Pa | |
|
11130 Capital Blvd Wake Forest NC 27587-4513 | |
| (919) 488-4094 | |
| (919) 488-0022 |
| Full Name | Growing Child Pediatrics, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 11130 Capital Blvd, Wake Forest, North Carolina |
| Authorized Official Name and Position | James Morrison Poole (OWNER) |
| Authorized Official Contact | 9194880015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Growing Child Pediatrics, Pa 260 Horizon Dr Raleigh NC 27615-4922 Ph: (919) 488-0015 | Growing Child Pediatrics, Pa 11130 Capital Blvd Wake Forest NC 27587-4513 Ph: (919) 488-4094 |
| NPI Number | 1487883781 |
|---|---|
| Provider Enumeration Date | 07/08/2009 |
| Last Update Date | 05/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487883781 | NPI | - | NPPES |
| 6008735 | Medicaid | NC | |
| 6008733 | Medicaid | NC | |
| 6006881 | Medicaid | NC | |
| 6008736 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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