Provider Demographics
NPI:1770697039
Name:OSTEOPATHIC MEDICAL ARTS, PC
Entity type:Organization
Organization Name:OSTEOPATHIC MEDICAL ARTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOTYKA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-401-4515
Mailing Address - Street 1:727 EASTOWNE DR.
Mailing Address - Street 2:SUITE 200 A
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2297
Mailing Address - Country:US
Mailing Address - Phone:919-401-4515
Mailing Address - Fax:919-401-4514
Practice Address - Street 1:727 EASTOWNE DR
Practice Address - Street 2:SUITE 200 A
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2297
Practice Address - Country:US
Practice Address - Phone:919-401-4515
Practice Address - Fax:919-401-4514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400233207R00000X
NC9600233207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891300JMedicaid
NCG37688Medicare UPIN
NC891300JMedicaid