Organization
DEBNAM CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE GEORGETTE DEBNAM M.D. (PRESIDENT)
(919) 832-1667
Entity
Organization
Contact information
Practice address
524 S BLOUNT ST, RALEIGH, NC 27601-1828
(919) 832-1667
Mailing address
1501 POOLE RD, RALEIGH, NC 27610-2656
(919) 832-1667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197H
BCBSNC
NC
05
—
890197H
—
NC
Enumeration date
05/15/2007
Last updated
01/19/2017
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