Individual
MRS. ELIZABETH COLLEEN MCAVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11200 GOVERNOR MANLY WAY, SUITE 309, RALEIGH, NC 27614-8599
(919) 562-9410
(919) 562-2948
Mailing address
PO BOX 1107, WAKE FOREST, NC 27588-1107
(919) 562-9410
(919) 562-2948
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-05937
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518149368
—
NC
Enumeration date
12/04/2007
Last updated
03/17/2018
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