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General NPI Number Information
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NPI Number | 1205863297
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Entity Type | Organization
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Legal Business Name | CAPE FEAR NEONATOLOGY
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1638 OWEN DRIVE
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City | FAYETTEVILLE
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State | NC
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Zip | 28302
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Country | US
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Telephone | 910-223-1339
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Fax | 910-486-6502
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Provider Business Mailing Address
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Address Line | 1638 OWEN DRIVE
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City | FAYETTEVILLE
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State | NC
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Zip | 28302
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Country | US
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Telephone | 910-609-6762
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Fax | 910-486-6502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS ARTHUR CISZEK
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Credential | M.D.
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Telephone | 910-609-6764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 29541
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License Number State | NC
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