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Organization

PRIVATE DIAGNOSTIC CLINIC, PLLC

Active
Other names
Pediatric Primary Care Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL R. NEWMAN (EXECUTIVE DIRECTOR)
(919) 620-4855
Entity
Organization

Contact information

Practice address
4020 N ROXBORO ST, DURHAM, NC 27704-2120
(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
208000000X
Pediatrics Physician
NC
208000000X
Pediatrics Physician
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
01/26/2007
Last updated
07/11/2022
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