Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Lumberton Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
1200 PINE RUN DR, LUMBERTON, NC 28358-2180
(910) 671-5730
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108F
BCBS
NC
05
—
790108F
—
NC
Enumeration date
01/25/2007
Last updated
05/13/2022
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