Provider Demographics
NPI:1396732301
Name:NC ARTHRITIS & ALLERGY CARE CENTER PA
Entity type:Organization
Organization Name:NC ARTHRITIS & ALLERGY CARE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:WOODROW
Authorized Official - Last Name:STRADER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-781-9633
Mailing Address - Street 1:3831 MERTON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6605
Mailing Address - Country:US
Mailing Address - Phone:919-781-9633
Mailing Address - Fax:919-781-1748
Practice Address - Street 1:3831 MERTON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6605
Practice Address - Country:US
Practice Address - Phone:919-781-9633
Practice Address - Fax:919-781-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902527Medicaid
NC3708OtherWELLPATH
NC02527OtherBCBS
NC02527OtherBCBS