Organization
PRIVATE DIAGNOSTIC CLINIC PLLC
Active
Other names
Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
20 DUKE MEDICINE CIRCLE, DURHAM, NC 27710-2000
(919) 684-8111
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208800000X
Urology Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
11/17/2011
Last updated
05/18/2022
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