Organization
OAK ISLAND PEDIATRICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUGTA KAHAI M.D., F.A.A.P. (PRESIDENT)
(910) 457-0070
Entity
Organization
Contact information
Practice address
4734 LONG BEACH RD SE, SOUTHPORT, NC 28461-8721
(910) 457-0070
(910) 457-0062
Mailing address
4734 LONG BEACH RD SE, SOUTHPORT, NC 28461-8721
(910) 457-0070
(910) 457-0062
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4773
NC
103T00000X
Psychologist
3068
NC
208000000X
Pediatrics Physician
Primary
9900076
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017HM
BCBSNC
NC
05
—
PENDING
—
NC
Enumeration date
01/12/2006
Last updated
11/20/2012
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