Organization
KNOX PEDIATRICS OF BRUNSWICK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINA EDRALIN KNOX MD (ADMINISTRATOR)
(910) 763-3349
Entity
Organization
Contact information
Practice address
20 MEDICAL CAMPUS DR., SUITE 207, SUPPLY, NC 28462-4094
(910) 755-5066
(910) 755-5099
Mailing address
20 MEDICAL CAMPUS DR., SUITE 207, SUPPLY, NC 28462-4092
(910) 755-5066
(910) 755-5099
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16200
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841218716
NPI
NC
05
—
5903109
—
NC
05
—
8949897
—
NC
Enumeration date
11/29/2006
Last updated
04/04/2011
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