Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Regional Neurosurgery
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
3901 N ROXBORO ST, SUITE 101, DURHAM, NC 27704-2181
(919) 479-4120
(919) 479-4237
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
11/22/2011
Last updated
05/13/2022
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