Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Southeastern Nephrology Assoc
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
1302 MEDICAL CENTER DR, WILMINGTON, NC 28401-7503
(910) 763-4401
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
04/18/2011
Last updated
07/11/2022
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