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General NPI Number Information
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NPI Number | 1073027033
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Entity Type | Organization
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Legal Business Name | CARY PSYCHIATRY
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 1616 EVANS RD STE 204
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City | CARY
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State | NC
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Zip | 27513-9653
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Country | US
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Telephone | 919-378-9761
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Fax | 919-234-0494
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Provider Business Mailing Address
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Address Line | 1616 EVANS RD STE 204
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City | CARY
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State | NC
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Zip | 27513-9653
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Country | US
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Telephone | 919-378-9761
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Fax | 919-234-0494
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/PSYCHIATRIST
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Name | ALLISON ROSE MIKEL
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Credential | MD
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Telephone | 919-378-9761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0010-04309
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License Number State | NC
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