Provider Demographics
NPI:1326268038
Name:CAROLINA NEUROLOGY & ELECTROMYOGRAPHY PA
Entity Type:Organization
Organization Name:CAROLINA NEUROLOGY & ELECTROMYOGRAPHY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-758-0806
Mailing Address - Street 1:707 W H SMITH BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-758-0806
Mailing Address - Fax:252-551-5721
Practice Address - Street 1:707 W H SMITH BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-758-0806
Practice Address - Fax:252-551-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty