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Organization

RALEIGH DURHAM MEDICAL GROUP, PA

Active
Parent organization
RALEIGH DURHAM MEDICAL GROUP PA
Other names
North Raleigh Pediatric Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Authorized official
DAVID K MOYE (EXECUTIVE DIRECTOR)
(919) 614-0301
Entity
Organization

Contact information

Practice address
7205 STONEHENGE DR, RALEIGH, NC 27613-1649
(919) 848-2249
(919) 848-8238
Mailing address
PO BOX 63103, CHARLOTTE, NC 28263-3103
(919) 233-5952
(312) 324-7850

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0237N
BCBS
NC
05
5900360
NC
Enumeration date
05/15/2006
Last updated
09/04/2024
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