Individual
JEROME J MAGOLAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3320 EXECUTIVE DR, STE 111, RALEIGH, NC 27609-7445
(919) 876-2427
(919) 850-9234
Mailing address
3320 EXECUTIVE DR, STE 111, RALEIGH, NC 27609-7445
(919) 876-2427
(919) 850-9234
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
29002
NC
207W00000X
Ophthalmology Physician
Primary
29002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
795372
—
NC
Enumeration date
02/08/2007
Last updated
06/18/2015
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