| Organization Name: | PRIVATE DIAGNOSTIC CLINIC, PLLC |
| NPI Number: | 1851587562 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK L CANTRELL (CHIEF PRIVACY & COMPLIANCE OFFICER) |
| Mailing Address: | 3480 Wake Forest Rd Suite 404 Raleigh |
| State: | NC US |
| Postal Code: | 276097376 |
| Phone Number: | 9198625730 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2007 |
| NPI Last Update Date: | 12/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |