Healthcare Provider Details

I. General information

NPI: 1396732301
Provider Name (Legal Business Name): NC ARTHRITIS & ALLERGY CARE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 MERTON DR
RALEIGH NC
27609-6605
US

IV. Provider business mailing address

3831 MERTON DR
RALEIGH NC
27609-6605
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-9633
  • Fax: 919-781-1748
Mailing address:
  • Phone: 919-781-9633
  • Fax: 919-781-1748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: KYLE WOODROW STRADER
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 919-781-9633