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Organization
DURHAM NEPHROLOGY ASSOCIATES PA
Active
Organization
DURHAM NEPHROLOGY ASSOCIATES PA
Active
Other names
Durham Nephrology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES IAN COOPERBERG MD (PRESIDENT)
(919) 477-3005
Entity
Organization
Contact information
Practice address
4419 BEN FRANKLIN BLVD, DURHAM, NC 27704-2147
(919) 477-3005
(919) 477-5526
Mailing address
4419 BEN FRANKLIN BLVD, DURHAM, NC 27704-2147
(919) 477-3005
(919) 477-5526
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166C
BLUE CROSS BLUE SHIELD
NC
05
—
890166C
—
NC
01
—
CG4698
MEDICARE RAILROAD
—
Enumeration date
10/17/2006
Last updated
04/30/2019
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