| North Raleigh Psychiatry, Pa | |
|
5530 Munford Rd Suite 119 Raleigh NC 27612-2638 | |
| (919) 782-9554 | |
| (919) 782-9130 |
| Full Name | North Raleigh Psychiatry, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5530 Munford Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Jeffrey Louis Snow (PRESIDENT) |
| Authorized Official Contact | 9197829554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Raleigh Psychiatry, Pa 5530 Munford Rd Suite 119 Raleigh NC 27612-2638 Ph: (919) 782-9554 | North Raleigh Psychiatry, Pa 5530 Munford Rd Suite 119 Raleigh NC 27612-2638 Ph: (919) 782-9554 |
| NPI Number | 1073610119 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 02/26/2014 |
| Medicare PECOS PAC ID | 5092724278 |
|---|---|
| Medicare Enrollment ID | O20060417000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073610119 | NPI | - | NPPES |
| 0144F | Other | NC | NC BLUE CROSSBLUE SHIELD |
| 890144F | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | John P Olarte |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538278593 PECOS PAC ID: 0547279531 Enrollment ID: I20060419000784 |
| Provider Name | Jeffrey Louis Snow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518064625 PECOS PAC ID: 1456360635 Enrollment ID: I20110113001012 |
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