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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
Family Wellness Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Authorized official
DAVID K MOYE (EXECUTIVE DIRECTOR)
(919) 851-2174
Entity
Organization
Contact information
Practice address
2076 HIGHWAY 42 W, SUITE 230, CLAYTON, NC 27520-5303
(919) 553-5711
(919) 553-5712
Mailing address
5420 WADE PARK BLVD, STE 106, RALEIGH, NC 27607-4188
(919) 233-5952
(919) 854-7774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025VY
BCBS
NC
Enumeration date
05/15/2006
Last updated
03/31/2014
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