Provider Demographics
NPI:1821224197
Name:HILLSBOROUGH PEDIATRIC AND ADOLESCENT MEDICINE PLLC
Entity Type:Organization
Organization Name:HILLSBOROUGH PEDIATRIC AND ADOLESCENT MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:CLEPPER-FAITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-245-3344
Mailing Address - Street 1:1000 CORPORATE DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8535
Mailing Address - Country:US
Mailing Address - Phone:919-245-3344
Mailing Address - Fax:919-245-3308
Practice Address - Street 1:1000 CORPORATE DR
Practice Address - Street 2:SUITE 401
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8535
Practice Address - Country:US
Practice Address - Phone:919-245-3344
Practice Address - Fax:919-245-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94-00754261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care