Individual
MR. GREGORY ATIKA ISABWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607
(919) 784-7093
(919) 784-7395
Mailing address
116 SUNFLOWER WAY, CLAYTON, NC 27527-9292
(781) 308-4106
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5009842
NC
Other
Enumeration date
09/01/2017
Last updated
04/01/2021
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