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Organization
SOUTHWEST DURHAM FAMILY MEDICINE, PLLC
Active
Organization
SOUTHWEST DURHAM FAMILY MEDICINE, PLLC
Active
Other names
SW Durham Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY MARUM M.D. (MANAGING PHYSICIAN)
(919) 419-0242
Entity
Organization
Contact information
Practice address
1515 W NC HWY 54, STE 130, DURHAM, NC 27707
(919) 419-0242
(919) 401-4172
Mailing address
1515 W NC HWY 54, STE 130, DURHAM, NC 27707
(919) 419-0242
(919) 401-4172
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200300258
NC
207R00000X
Internal Medicine Physician
9700021
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017RT
BLUE CROSS BLUE SHIELD
NC
Enumeration date
01/30/2006
Last updated
09/21/2022
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