Organization
COASTAL NEUROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALED JREISAT MD (PHYSICIAN)
(252) 633-3744
Entity
Organization
Contact information
Practice address
729 PROFESSIONAL DR, NEW BERN, NC 28560-4547
(252) 633-3744
Mailing address
729 PROFESSIONAL DR, NEW BERN, NC 28560-4547
(252) 633-3744
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01344
BLUE CROSS GROUP NUMBER
NC
01
—
12867
BALLANGER INDIVIDUAL #
NC
01
—
45782
JREISAT BCBS INDIVIDUAL
NC
05
—
8901344
—
NC
05
—
8912867
—
NC
05
—
8945782
—
NC
Enumeration date
04/12/2007
Last updated
02/15/2010
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