Provider Demographics
NPI:1205863297
Name:CAPE FEAR NEONATOLOGY
Entity Type:Organization
Organization Name:CAPE FEAR NEONATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:CISZEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-609-6764
Mailing Address - Street 1:1638 OWEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302
Mailing Address - Country:US
Mailing Address - Phone:910-609-6762
Mailing Address - Fax:910-486-6502
Practice Address - Street 1:1638 OWEN DRIVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28302
Practice Address - Country:US
Practice Address - Phone:910-223-1339
Practice Address - Fax:910-486-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29541174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty