Individual
BASEL MATALKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5275 US HIGHWAY 158, BERMUDA RUN, NC 27006-6905
(336) 940-4010
Mailing address
844 NEWINGTON DR, CLEMMONS, NC 27012-8672
(828) 423-9469
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18530
NC
Other
Enumeration date
01/25/2013
Last updated
12/12/2018
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