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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396843132 NPPES
North Carolina MEDICAID 89133VH

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