Provider Demographics
NPI:1003000118
Name:STEVEN ENGEL PEDIATRICS
Entity type:Organization
Organization Name:STEVEN ENGEL PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-637-3799
Mailing Address - Street 1:1700 NEUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-2304
Mailing Address - Country:US
Mailing Address - Phone:252-637-3799
Mailing Address - Fax:252-633-0944
Practice Address - Street 1:1700 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-2304
Practice Address - Country:US
Practice Address - Phone:252-637-3799
Practice Address - Fax:252-633-0944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20789208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8930670Medicaid
NC30670OtherBCBS