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Individual

MS. ENID MATOS TALLMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4822 SIX FORKS RD, RALEIGH, NC 27609-5269
(919) 334-0245
Mailing address
1313 FALLS CHURCH RD, RALEIGH, NC 27609-4048
(919) 790-3532

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-00265
NC

Other

Enumeration date
04/27/2006
Last updated
02/27/2009
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