Healthcare Provider Details

I. General information

NPI: 1194200741
Provider Name (Legal Business Name): JOSEPH ALAN KIROLLOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2018
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NEW BERN AVE
RALEIGH NC
27610-1231
US

IV. Provider business mailing address

2080 W ARLINGTON BLVD STE B
GREENVILLE NC
27834-3770
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-8000
  • Fax:
Mailing address:
  • Phone: 252-752-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2026-01513
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: