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Organization
RALEIGH DURHAM MEDICAL GROUP PA
Active
Organization
RALEIGH DURHAM MEDICAL GROUP PA
Active
Parent organization
RALEIGH DURHAM MEDICAL GROUP PA
Other names
Waverly Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Authorized official
DAVID K MOYE (SENIOR VICE PRESIDENT)
(919) 614-0301
Entity
Organization
Contact information
Practice address
600 NEW WAVERLY PLACE, STE 203, CARY, NC 27518
(919) 859-5650
(919) 859-5695
Mailing address
PO BOX 96860, CHARLOTTE, NC 28296-6860
(919) 233-5952
(312) 324-7850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231T
BCBS
NC
05
—
5900362
—
NC
Enumeration date
05/16/2006
Last updated
03/07/2025
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