Healthcare Provider Details

I. General information

NPI: 1639829724
Provider Name (Legal Business Name): PIERCE KNOX DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 CREEDMOOR RD STE 102
RALEIGH NC
27613-1711
US

IV. Provider business mailing address

501 W 14TH ST
WILMINGTON DE
19801-1013
US

V. Phone/Fax

Practice location:
  • Phone: 919-526-0015
  • Fax:
Mailing address:
  • Phone: 302-733-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number202602945
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: