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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
Durham Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Authorized official
DAVID K MOYE (EXECUTIVE DIRECTOR)
(919) 614-0301
Entity
Organization
Contact information
Practice address
2400 BROAD ST, STE 1, DURHAM, NC 27704-2661
(919) 220-9800
(919) 220-9500
Mailing address
PO BOX 63103, CHARLOTTE, NC 28263-3103
(919) 233-5952
(312) 324-7850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023N5
BCBS
NC
05
—
5915531
—
NC
Enumeration date
08/05/2010
Last updated
07/16/2021
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