Organization · NPI-2

Brainmatters Neurology PLLC

Psychiatry & Neurology, Neurology · Jacksonville, NC

NPI number1407662455
StatusActive
Last updated in NPPESMar 7, 2026

Details

NPI
1407662455
Entity type
Organization (NPI-2)
Legal business name
Brainmatters Neurology PLLC
Organization subpart
No
Enumeration date
Dec 4, 2024
Certification date
Mar 7, 2026
Last updated
Mar 7, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology––Yes

Practice location

3391 Henderson Dr
Jacksonville, NC 28546-5231

Phone 910-333-0026 · Fax 800-759-6517

Mailing address

3391 Henderson Dr
Jacksonville, NC 28546-5231

Phone 910-333-0026 · Fax 800-759-6517

Authorized official

Sasidharan Taravath
President/Ceo
9103330026

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