| Oak Island Pediatrics, P.a. | |
|
4734 Long Beach Rd Se Southport NC 28461-8721 | |
| (910) 457-0070 | |
| (910) 457-0062 |
| Full Name | Oak Island Pediatrics, P.a. |
|---|---|
| Speciality | Pediatrics |
| Location | 4734 Long Beach Rd Se, Southport, North Carolina |
| Authorized Official Name and Position | Jugta Kahai (PRESIDENT) |
| Authorized Official Contact | 9104570070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Island Pediatrics, P.a. 4734 Long Beach Rd Se Southport NC 28461-8721 Ph: (910) 457-0070 | Oak Island Pediatrics, P.a. 4734 Long Beach Rd Se Southport NC 28461-8721 Ph: (910) 457-0070 |
| NPI Number | 1205815685 |
|---|---|
| Provider Enumeration Date | 01/12/2006 |
| Last Update Date | 11/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205815685 | NPI | - | NPPES |
| 017HM | Other | NC | BCBSNC |
| PENDING | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 4773 (North Carolina) | Secondary |
| 103T00000X | Psychologist | 3068 (North Carolina) | Secondary |
| 208000000X | Pediatrics | 9900076 (North Carolina) | Primary |
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