# PRIVATE DIAGNOSTIC CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Duke Electrophysiology Consultative Clinic of Danville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215251244
- **Authorized official:** CHRISTOPHER THOMAS FREDERICK (CFO)
- **Authorized official phone:** (919) 613-7762

## Contact information

- **Practice address:** 201 S. MAIN STREET, SUITE 1100A, DANVILLE, VA 24541-2938
- **Practice address phone:** (434) 791-3009
- **Mailing address:** PO BOX 110566, DURHAM, NC 27709-5566
- **Mailing address phone:** (919) 620-4485
- **Mailing address fax:** (919) 620-4291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | Yes |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2010
- **Last updated:** 05/15/2022