Provider Demographics
NPI:1467455329
Name:BHOTIWIHOK, PREECHA (MD)
Entity Type:Individual
Prefix:DR
First Name:PREECHA
Middle Name:
Last Name:BHOTIWIHOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16068
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-6068
Mailing Address - Country:US
Mailing Address - Phone:888-447-7220
Mailing Address - Fax:336-884-1643
Practice Address - Street 1:100 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1604
Practice Address - Country:US
Practice Address - Phone:800-277-8151
Practice Address - Fax:336-841-6217
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22212207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7915415Medicaid
NC201896AMedicare ID - Type Unspecified
NC7915415Medicaid