Organization Name: | RALEIGH DURHAM MEDICAL GROUP, PA |
NPI Number: | 1194096289 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID MOYE (EXECUTIVE DIRECTOR) |
Mailing Address: | 107 Weeks Dr Roxboro |
State: | NC US |
Postal Code: | 275733933 |
Phone Number: | 3365985480 |
Fax Number: | 3365985482 |
NPI Enumeration Date: | 01/20/2012 |
NPI Last Update Date: | 02/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |