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Organization

PRIVATE DIAGNOSTIC CLINIC, PLLC

Active
Other names
Harris & Smith OB-GYN
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization

Contact information

Practice address
5324 MCFARLAND DRIVE, SUITE 200, DURHAM, NC 27707-6864
(919) 967-8052
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01012
BCBS GRP
NC
05
890126T
NC
Enumeration date
07/10/2006
Last updated
07/11/2022
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