Organization
PRIVATE DIAGNOSTIC CLINIC PLLC
Active
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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