Individual
DR. JONATHAN GREGORY BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4020 N ROXBORO ST, DURHAM, NC 27704-2120
(919) 620-5333
Mailing address
1406 FAIRMONT ST, DURHAM, NC 27713-8981
(919) 450-0604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
127866
NC
208000000X
Pediatrics Physician
127866
NC
Other
Enumeration date
04/09/2008
Last updated
04/09/2008
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