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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
Carolina Family Practice & Sports Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Authorized official
DAVID K MOYE (SENIOR VICE PRESIDENT)
(919) 851-2174
Entity
Organization
Contact information
Practice address
3700 NW CARY PKWY, CARY, NC 27513-8422
(919) 238-2000
(919) 238-5010
Mailing address
5400 TRINITY RD, STE 105, RALEIGH, NC 27607-6001
(919) 851-2174
(919) 854-7774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014RU
BCBS
NC
Enumeration date
05/16/2006
Last updated
09/21/2007
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