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Organization
WILLOW FAMILY MEDICAL CENTER
Active
Organization
WILLOW FAMILY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE D TOLLEFSON M.D. (PRESIDENT)
(919) 806-8686
Entity
Organization
Contact information
Practice address
3434 EDWARDS MILL RD STE 112 PMB 348, RALEIGH, NC 27612-4276
(919) 806-8686
(919) 787-2176
Mailing address
3434 EDWARDS MILL RD STE 112 PMB 348, RALEIGH, NC 27612-4276
(919) 806-8686
(919) 787-2176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02150
BCBS GROUP
NC
01
—
2242750
UNITED HEALTHCARE
NC
01
—
39308
WELLPATH COVENTRY
NC
Enumeration date
02/14/2007
Last updated
09/10/2010
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