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Individual

JOHN BRYAN LYKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 235-6505
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2015-00448
NC
208000000X
Pediatrics Physician
MD041473
DC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053637181
NC
Enumeration date
04/14/2010
Last updated
04/24/2024
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