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General NPI Number Information
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NPI Number | 1205892916
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Entity Type | Organization
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Legal Business Name | PINEHURST NEUROLOGY, PA
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1 PAGE RD
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City | PINEHURST
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State | NC
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Zip | 28374-8745
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Country | US
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Telephone | 910-295-6868
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Fax | 910-295-1514
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Provider Business Mailing Address
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Address Line | PO BOX 1749
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City | PINEHURST
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State | NC
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Zip | 28370-1749
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Country | US
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Telephone | 910-295-6868
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Fax | 910-295-1514
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Authorized Official
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Title or Position | NEUROLOGIST/PRESIDENT
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Name | BRUCE SOLOMON
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Credential | DO
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Telephone | 910-295-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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