Organization
DIRECT MEDICAL XPERIENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAUNDRE ALFONZO DYER D.O. (MEDICAL DIRECTOR)
(919) 944-9935
Entity
Organization
Contact information
Practice address
4505 FAIR MEADOWS LN STE 215, RALEIGH, NC 27607-6449
(919) 944-9935
Mailing address
11845 RETAIL DR # 1079, WAKE FOREST, NC 27587-7352
(919) 944-9935
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/18/2024
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