Organization
RETINA INSTITUTE OF NORTH CAROLINA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA FOGEL MD (OWNER)
(919) 787-8555
Entity
Organization
Contact information
Practice address
3211 ROGERS RD, STE 101, WAKE FOREST, NC 27587-3890
(919) 453-1462
(919) 453-1473
Mailing address
2605 BLUE RIDGE RD, STE 220, RALEIGH, NC 27607-6475
(919) 787-8555
(919) 787-8112
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2006-00726
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903995
—
NC
Enumeration date
12/15/2009
Last updated
12/15/2009
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