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Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Southeastern Nephrology Assoc
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
1302 MEDICAL CENTER DR, WILMINGTON, NC 28401-7503
(910) 763-4401
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
04/18/2011
Last updated
07/11/2022
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