Provider Demographics
NPI:1598411407
Name:CARDINAL HEADACHE CENTER
Entity Type:Organization
Organization Name:CARDINAL HEADACHE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:PETER
Authorized Official - Middle Name:T
Authorized Official - Last Name:KALOGERINIS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C, DMSC
Authorized Official - Phone:910-584-8185
Mailing Address - Street 1:PO BOX 87854
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-7854
Mailing Address - Country:US
Mailing Address - Phone:910-584-8185
Mailing Address - Fax:
Practice Address - Street 1:518 BEAUMONT RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4446
Practice Address - Country:US
Practice Address - Phone:910-775-3130
Practice Address - Fax:910-775-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty