# PRIVATE DIAGNOSTIC CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Duke Pernatal Consultants Durham
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205159316
- **Authorized official:** CHRISTOPHER THOMAS FREDERICK (CFO)
- **Authorized official phone:** (919) 613-7762

## Contact information

- **Practice address:** 2608 ERWIN RD STE 200, DURHAM, NC 27705-4597
- **Practice address phone:** (919) 684-6327
- **Mailing address:** PO BOX 110566, DURHAM, NC 27709-5566
- **Mailing address phone:** (919) 620-4855
- **Mailing address fax:** (919) 620-4921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/03/2010
- **Last updated:** 05/13/2022