Organization
RALEIGH DURHAM MEDICAL GROUP, PA
Active
Parent organization
RALEIGH DURHAM MEDICAL GROUP PA
Other names
Stepping Stones Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Authorized official
DAVID K MOYE (SENIOR VICE PRESIDENT)
(919) 851-2174
Entity
Organization
Contact information
Practice address
10941 RAVEN RIDGE RD, STE 105, RALEIGH, NC 27614-6487
(919) 235-0543
(919) 235-0542
Mailing address
5400 TRINITY RD, STE 105, RALEIGH, NC 27607-6001
(919) 851-2174
(919) 854-7774
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013ET
BCBS
NC
05
—
89013ET
—
NC
Enumeration date
05/16/2006
Last updated
09/21/2007
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