# PRIVATE DIAGNOSTIC CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DUKE CHILDREN'S PRIMARY CARE BRIER CREEK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639617392
- **Authorized official:** KENNI WATKINS (FINANICAL CARE COUNSLOR)
- **Authorized official phone:** (919) 307-0301

## Contact information

- **Practice address:** 10211 ALM ST, SUITE 200, RALEIGH, NC 27617-8221
- **Practice address phone:** (919) 307-0301
- **Practice address fax:** (919) 307-0323
- **Mailing address:** 10211 ALM ST, SUITE 200, RALEIGH, NC 27617-8221
- **Mailing address phone:** (919) 307-0301
- **Mailing address fax:** (919) 307-0323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | 1134395114 | NC | — |
| 261QP2300X | Primary Care Clinic/Center | 1386819795 | NC | — |
| 261QP2300X | Primary Care Clinic/Center | 1447306113 | NC | Yes |
| 261QP2300X | Primary Care Clinic/Center | 1598007866 | NC | — |
| 261QP2300X | Primary Care Clinic/Center | 1760566624 | NC | — |
| 261QP2300X | Primary Care Clinic/Center | 1881778785 | NC | — |

## Other

- **Enumeration date:** 02/02/2017
- **Last updated:** 02/02/2017