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NPI Code Detail

MEDICARE: OCEANSIDE PEDIATRICS

MEDICARE: OCEANSIDE PEDIATRICS
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
1208000000XPediatrics Physician153474NC

General Provider Information

NPI Number : 1750526257
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCEANSIDE PEDIATRICS
Provider Business Mailing Address
First Line : 3701 JOHN PLATT DR
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4372
Country : US
Telephone Number : 252-622-4448
Fax Number : 252-622-4014
Provider Business Practice Location Address
First Line : 3701 JOHN PLATT DR
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4372
Country : US
Telephone Number : 252-622-4448
Fax Number : 252-622-4014
Authorized Official
Title or Position : OWNER
Name : DR. ANDREW KENNETH KILUK
Credential : MD
Telephone Number : 252-622-4448
Provider Enumeration Date : 12/11/2008
Last Update Date : 07/27/2012

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Directions to “OCEANSIDE PEDIATRICS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.