Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Raleigh Pulmonary & Allergy Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
3480 WAKE FOREST RD, SUITE 414, RALEIGH, NC 27609-7376
(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
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017VW
BCBS GRP
NC
05
—
7907025
—
NC
Enumeration date
07/15/2006
Last updated
07/11/2022
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