Organization
ESSEX PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERINE IBRAHIM M.D. (OWNER)
(919) 751-9120
Entity
Organization
Contact information
Practice address
4016 BARRETT DR, SUITE 101, RALEIGH, NC 27609-6623
(919) 751-9120
(919) 751-9170
Mailing address
4016 BARRETT DR, SUITE 101, RALEIGH, NC 27609-6623
(919) 751-9120
(919) 751-9170
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0244E
BCBS GROUP
NC
05
—
7945199
—
NC
Enumeration date
05/18/2006
Last updated
10/29/2008
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