Provider Demographics
NPI:1053549881
Name:NEW BERN ARTHRITIS CENTER PLLC
Entity type:Organization
Organization Name:NEW BERN ARTHRITIS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-672-8400
Mailing Address - Street 1:1706 HIGHWAY 70 E
Mailing Address - Street 2:SUITE D
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-6856
Mailing Address - Country:US
Mailing Address - Phone:252-672-8400
Mailing Address - Fax:252-672-8401
Practice Address - Street 1:1706 HIGHWAY 70 E
Practice Address - Street 2:SUITE D
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-6856
Practice Address - Country:US
Practice Address - Phone:252-672-8400
Practice Address - Fax:252-672-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38137207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8957265Medicaid
NC8957265Medicaid