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General NPI Number Information
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NPI Number | 1366510182
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Entity Type | Individual
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Provider Name | RICHARD ALLAN KNAZEK M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4500 CARTERET DR
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City | TRENT WOODS
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State | NC
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Zip | 28562-7209
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Country | US
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Telephone | 252-634-1769
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 CARTERET DR
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City | TRENT WOODS
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State | NC
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Zip | 28562-7209
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Country | US
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Telephone | 252-634-1769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | D0023564
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License Number State | MD
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