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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
Roxboro Family Medicine & Immediate Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Authorized official
DAVID MOYE (EXECUTIVE DIRECTOR)
(919) 851-2174
Entity
Organization
Contact information
Practice address
107 WEEKS DR, ROXBORO, NC 27573-3933
(336) 598-5480
(336) 598-5482
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
—
—
207VG0400X
Gynecology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025VU
BCBS
NC
05
—
5919299
—
NC
Enumeration date
01/20/2012
Last updated
02/05/2014
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