Provider Demographics
NPI:1568916021
Name:KESETE, PAULOS (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAULOS
Middle Name:
Last Name:KESETE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-7634
Mailing Address - Country:US
Mailing Address - Phone:919-453-0932
Mailing Address - Fax:919-453-0978
Practice Address - Street 1:3601 ROGERS RD
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-7634
Practice Address - Country:US
Practice Address - Phone:919-453-0932
Practice Address - Fax:919-453-0978
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist