Organization
RALEIGH DURHAM MEDICAL GROUP PA
Active
Parent organization
RALEIGH DURHAM MEDICAL GROUP PA
Other names
Advanced Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Authorized official
DAVID K MOYE (SENIOR VICE PRESIDENT)
(919) 851-2174
Entity
Organization
Contact information
Practice address
530 NEW WAVERLY PL, STE. 304, CARY, NC 27518-7414
(919) 851-9193
(919) 851-9223
Mailing address
5420 WADE PARK BLVD, STE. 106, RALEIGH, NC 27607-4188
(919) 851-2174
(919) 854-7774
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016W6
BCBS
NC
05
—
5900017
—
NC
Enumeration date
09/21/2007
Last updated
03/05/2009
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