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General NPI Number Information
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NPI Number | 1750422929
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Entity Type | Organization
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Legal Business Name | CAPITAL NEUROSCIENCE PA
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 3402 MANDY LN
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-3161
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Country | US
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Telephone | 252-726-7705
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Fax | 252-726-7278
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Provider Business Mailing Address
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Address Line | 3402 MANDY LN
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-3161
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Country | US
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Telephone | 252-726-7705
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Fax | 252-726-7703
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JAMES T PATRICK
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Credential | MD
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Telephone | 252-726-7705
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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 | 34520
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License Number State | NC
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