Healthcare Provider Details

I. General information

NPI: 1437333465
Provider Name (Legal Business Name): EXCEL PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 TILGHMAN DRIVE SUITE 300
DUNN NC
28334-5507
US

IV. Provider business mailing address

145 TILGHMAN DRIVE SUITE 300
DUNN NC
28334-5507
US

V. Phone/Fax

Practice location:
  • Phone: 910-891-5437
  • Fax: 910-891-5437
Mailing address:
  • Phone: 910-891-5437
  • Fax: 910-897-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier891325R
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: DR. DURGA ALAHARI
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 910-891-5437