Individual
KEVIN MANOCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 231-9623
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
58109
MN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2021-01012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518304625
—
NC
Enumeration date
05/30/2013
Last updated
08/09/2021
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