Jreisat, Khaled F
Jreisat, Khaled F is an individual health care provider with primary practice located at 3806 Peachtree Ave Suite 110, Wilmington NC 28403-6751. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is his primary health care specialty. Jreisat, Khaled F can be contacted via phone (910) 399-4197.Contact Information
Primary practice address
3806 Peachtree Ave Suite 110
Wilmington NC 28403-6751
Phone: (910) 399-4197
Fax: (910) 399-4223
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 11599 | North Carolina |
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology | 2084N0402X | 27377 | North Carolina |
Profile Details
NPI number | 1396843132 |
---|---|
LBN Legal business name | Jreisat, Khaled F |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 20th, 2006 |
Last updated | Aug 29th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396843132 | NPPES |
North Carolina | MEDICAID | 89133VH |
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