Organization
DAVIS GROVE PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM YAN PH.D. (MANAGER)
(919) 452-4761
Entity
Organization
Contact information
Practice address
204 DAVIS GROVE CIR STE 107, CARY, NC 27519-2581
(919) 363-3427
(919) 363-3437
Mailing address
204 DAVIS GROVE CIR STE 107, CARY, NC 27519-2581
(919) 363-3427
(919) 363-3437
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2008-00550
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5910793
—
NC
Enumeration date
01/15/2016
Last updated
01/15/2016
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