Organization
MED ONE MEDICAL GROUP
Active
Organization
MED ONE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY L. CONNER (INSURANCE AND BILLING MANAGER)
(919) 850-1300
Entity
Organization
Contact information
Practice address
7019-200 HARPS MILL RD., RALEIGH, NC 27615
(919) 850-1300
(919) 850-0012
Mailing address
7019-200 HARPS MILL RD., RALEIGH, NC 27615
(919) 850-1300
(919) 850-0012
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2394
NC
207R00000X
Internal Medicine Physician
930076
NC
207R00000X
Internal Medicine Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
0050-02018
NC
363LF0000X
Family Nurse Practitioner
201835
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-04356
LICENSE # - TYLER CASSIDY
NC
01
—
0050-02018
J. CHARLES ANP LISCENSE
NC
01
—
2394
G. GRUBER DC LICENSE #
NC
01
—
5011967
LICENSE # - KERNEY YU
NC
01
—
930076
CARA L. DAVIS LICENSE
NC
Enumeration date
10/27/2006
Last updated
03/07/2023
Update your record
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