Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Parent organization
PRIVATE DIAGNOSTIC CLINIC PLLC
Other names
Growing Child Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIVATE DIAGNOSTIC CLINIC PLLC
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
7990 ARCO CORPORATE DR, RALEIGH, NC 27617-2029
(919) 544-5900
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23168
NC
208000000X
Pediatrics Physician
Primary
23168
NC
Other
Enumeration date
01/19/2018
Last updated
05/15/2022
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