Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
RALEIGH DURHAM MEDICAL GROUP, PA
Active
Organization
RALEIGH DURHAM MEDICAL GROUP, PA
Active
Parent organization
RALEIGH DURHAM MEDICAL GROUP, PA
Other names
Seaside Wellness of Shallotte
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Authorized official
DAVID K. MOYE (EXECUTIVE DIRECTOR)
(919) 233-5956
Entity
Organization
Contact information
Practice address
4748 MAIN STREET, SHALLOTTE, NC 28470
(910) 754-2273
(910) 754-2254
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
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720458326
—
NC
Enumeration date
09/25/2015
Last updated
04/01/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up