# PRIVATE DIAGNOSTIC CLINIC, PLLC

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Durham OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962428466
- **Authorized official:** CHRISTOPHER THOMAS FREDERICK (CFO)
- **Authorized official phone:** (919) 613-7762

## Contact information

- **Practice address:** 2609 N DUKE ST, SUITE 204, DURHAM, NC 27704-3048
- **Practice address phone:** (919) 684-8111
- **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 |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 07/11/2022