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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
Conner Family Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Authorized official
DAVID K MOYE (EXECUTIVE DIRECTOR)
(919) 233-5952
Entity
Organization
Contact information
Practice address
211 W MATTHEWS ST, STE 102, MATTHEWS, NC 28105-1309
(704) 708-4301
(704) 708-4389
Mailing address
5420 WADE PARK BLVD, STE 106, RALEIGH, NC 27607-4188
(919) 233-5952
(919) 854-7774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027M3
BCBS
NC
Enumeration date
11/30/2012
Last updated
02/05/2014
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