# PRIVATE DIAGNOSTIC CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Women's Health Professionals
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568873768
- **Authorized official:** CHRISTOPHER T FREDERICK (CFO)
- **Authorized official phone:** (919) 620-4668

## Contact information

- **Practice address:** 1209 SE INDUSTRY DR, OXFORD, NC 27565
- **Practice address phone:** (252) 492-8576
- **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 |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2014
- **Last updated:** 07/11/2022