Pediaditakis, Nicholas

Pediaditakis, Nicholas is an sole proprietor health care provider with primary practice located at 5100 Lead Mine Rd , Raleigh NC 27612-3436. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Pediaditakis, Nicholas can be contacted via phone (919) 787-0710.

Contact Information

Primary practice address
5100 Lead Mine Rd Raleigh NC 27612-3436
Phone: (919) 787-0710
Fax: (919) 787-0710
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 13201 North Carolina
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 13201 North Carolina
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 13201 North Carolina

Profile Details

NPI number 1093847568
LBN Legal business name Pediaditakis, Nicholas
Credentials M.D., DLFAPA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 11th, 2007
Last updated Oct 8th, 2014 - about 11 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 1093847568 NPPES
North Carolina Other 66509 BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 8966509 BLUE CROSS BLUE SHIELD

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