NPI 1518214022

Carl Diedritch Sickerott

Practitioner Adult Care Home Facility Raleigh, NC

Practice location

Address: 2026 Fairview Rd, Raleigh, NC 27608-2316
Phone: (919) 946-1758

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence MHL-092-469 (NC)

Other Custodial Care Facility providers in North Carolina →

Registry record

NPI: 1518214022
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Aug 2012
Record last updated: 24 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.