Healthcare Provider Details

I. General information

NPI: 1508813155
Provider Name (Legal Business Name): ALAN D KRITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 MACON POND DR
RALEIGH NC
27607-6319
US

IV. Provider business mailing address

PO BOX 60106
CHARLOTTE NC
28260-0106
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-7070
  • Fax:
Mailing address:
  • Phone: 919-781-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number9601365
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: