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Organization

RAINBOW KIDS PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENEVIEVE SANATRA FAISON-ALSTON MD (MEDICAL DOCTOR)
(919) 435-1099
Entity
Organization

Contact information

Practice address
853 DURHAM RD, SUITE B, WAKE FOREST, NC 27587-8793
(919) 435-1099
(919) 435-1130
Mailing address
853 DURHAM RD, SUITE B, WAKE FOREST, NC 27587-8793
(919) 435-1099
(919) 435-1130

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9901171
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1258X
BCBS
NC
01
229108
UNITED
NC
01
331532
WELLPATH
NC
05
8912588
NC
Enumeration date
03/12/2015
Last updated
06/26/2015
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