Individual
DR. KURT THOMAS SCAVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4414 LAKE BOONE TRL STE 302, RALEIGH, NC 27607-7514
(919) 782-8038
(919) 782-8189
Mailing address
4414 LAKE BOONE TRL STE 302, RALEIGH, NC 27607-7514
(919) 782-8038
(919) 782-8189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT211057
PA
207W00000X
Ophthalmology Physician
Primary
2022-01043
NC
207W00000X
Ophthalmology Physician
60971
TN
207WX0107X
Retina Specialist (Ophthalmology) Physician
2022-01043
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427408228
—
NC
Enumeration date
06/13/2016
Last updated
07/15/2022
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