Organization
KIDZCARE PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTAE RENEE LOCKHART (CREDENTIAL ADMIN)
(910) 483-7337
Entity
Organization
Contact information
Practice address
853 DURHAM RD STE B, WAKE FOREST, NC 27587-8793
(919) 435-1099
(919) 435-1130
Mailing address
PO BOX 9219, FAYETTEVILLE, NC 28311-9082
(910) 483-7337
(910) 483-0648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200101222
NC
Other
Enumeration date
03/15/2016
Last updated
08/27/2021
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