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Organization

PRIVATE DIAGNOSTIC CLINIC, PLLC

Active
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Organization

PRIVATE DIAGNOSTIC CLINIC, PLLC

Active
Other names
Kernodle Clinic-West
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL R NEWMAN (EXECUTIVE DIRECTOR, PDC)
(919) 613-7652
Entity
Organization

Contact information

Practice address
1234 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 538-1234
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RP1001X
Pulmonary Disease Physician
207RR0500X
Rheumatology Physician
207RS0010X
Sports Medicine (Internal Medicine) Physician
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
2084N0400X
Neurology Physician
208D00000X
General Practice Physician
213E00000X
Podiatrist

Other

Enumeration date
03/13/2013
Last updated
05/15/2022
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