# PRIVATE DIAGNOSTIC CLINIC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Duke Gastroenterology of Raleigh
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700087194
- **Authorized official:** CHRISTOPHER THOMAS FREDERICK (CFO)
- **Authorized official phone:** (919) 613-7762

## Contact information

- **Practice address:** 3480 WAKE FOREST RD, SUITE 500, RALEIGH, NC 27609-7376
- **Practice address phone:** (919) 862-5075
- **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 |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 10/20/2022