Organization
KIDZCARE PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTAE RENEE LOCKHART (CREDENTIALING ADMIN)
(910) 483-7337
Entity
Organization
Contact information
Practice address
416 MCCULLOUGH DR STE 140, CHARLOTTE, NC 28262-4390
(704) 717-3383
(704) 717-3393
Mailing address
PO BOX 9219, FAYETTEVILLE, NC 28311-9082
(910) 483-7737
(910) 483-0648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/23/2020
Last updated
04/27/2020
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