MEDICARE: PIERCE KNOX DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	202602945	NC

General Provider Information

NPI Number	:	1639829724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERCE KNOX DO

Provider Business Mailing Address
First Line	:	501 W 14TH ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19801-1013
Country	:	US
Telephone Number	:	302-733-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 CREEDMOOR RD STE 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-1711
Country	:	US
Telephone Number	:	919-526-0015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	06/17/2026

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