Organization
KIDZCARE PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTAE RENEE LOCKHART (CREDENTIALING SPECIALIST)
(910) 483-7337
Entity
Organization
Contact information
Practice address
112 MEDICAL VILLAGE DR STE D, WALLACE, NC 28466-1665
(910) 665-1437
(910) 665-1315
Mailing address
5617 RAMSEY ST, FAYETTEVILLE, NC 28311-1423
(910) 483-7337
(910) 483-0648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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