# BROAD HEALTH OF NC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043955396
- **Authorized official:** DR. MILDRED SANTORUFO DO (OWNER)
- **Authorized official phone:** (706) 455-2406

## Contact information

- **Practice address:** 2626 GLENWOOD AVE STE 550, RALEIGH, NC 27608-1370
- **Practice address phone:** (706) 455-2406
- **Mailing address:** 154 W 16TH ST \# 6-110, NEW YORK, NY 10011-6201
- **Mailing address phone:** (617) 513-4838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2022
- **Last updated:** 05/02/2022