| Brainmatters Neurology Pllc | |
|
190 Valencia Dr Apt 303c Jacksonville NC 28546-7440 | |
| (910) 833-0356 | |
| Not Available |
| Full Name | Brainmatters Neurology Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 190 Valencia Dr Apt 303c, Jacksonville, North Carolina |
| Authorized Official Name and Position | Sasidharan Taravath (PRESIDENT/CEO) |
| Authorized Official Contact | 9108330356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainmatters Neurology Pllc Po Box 12086 Wilmington NC 28405-0107 Ph: (336) 310-4712 | Brainmatters Neurology Pllc 190 Valencia Dr Apt 303c Jacksonville NC 28546-7440 Ph: (910) 833-0356 |
| NPI Number | 1407662455 |
|---|---|
| Provider Enumeration Date | 12/04/2024 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407662455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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