Provider Demographics
NPI:1306067863
Name:CAPE CENTER PEDIATRICS P.A.
Entity type:Organization
Organization Name:CAPE CENTER PEDIATRICS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SREELEKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SASHIDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-677-0007
Mailing Address - Street 1:2109 VALLEYGATE DR
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3682
Mailing Address - Country:US
Mailing Address - Phone:910-677-0007
Mailing Address - Fax:910-677-0038
Practice Address - Street 1:2109 VALLEYGATE DR
Practice Address - Street 2:SUITE # 101
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3682
Practice Address - Country:US
Practice Address - Phone:910-677-0007
Practice Address - Fax:910-677-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601058208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty