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General NPI Number Information
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NPI Number | 1487782835
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Entity Type | Organization
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Legal Business Name | CELSO B. LOBAO, MD, PA
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 3020 FALSTAFF RD SUITE B
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City | RALEIGH
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State | NC
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Zip | 27610
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Country | US
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Telephone | 919-250-7346
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Fax | 888-259-7335
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Provider Business Mailing Address
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Address Line | PO BOX 14067
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City | RALEIGH
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State | NC
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Zip | 27620
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Country | US
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Telephone | 919-250-7246
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Fax | 888-259-7335
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. CELSO BENEDITO LOBAO
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Credential | MD
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Telephone | 919-250-7246
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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 | 35411
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License Number State | NC
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