Individual
ANDREA MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A158243
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
RTL21-0960
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A158243
STATE LICENSE
CA
Enumeration date
03/28/2017
Last updated
03/20/2024
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