Individual
KHALED F JREISAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3806 PEACHTREE AVE, SUITE 110, WILMINGTON, NC 28403-6751
(910) 399-4197
(910) 399-4223
Mailing address
34 OFFICE PARK DR, STE 100, JACKSONVILLE, NC 28546-3221
(910) 353-3624
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11599
NC
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
27377
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89133VH
—
NC
Enumeration date
09/20/2006
Last updated
08/29/2019
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