Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Smithfield Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
514 N BRIGHTLEAF BLVD, SUITE 1100, SMITHFIELD, NC 27577-4407
(919) 989-2192
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01012
BCBS GRP
NC
05
—
8902218
—
NC
Enumeration date
07/09/2006
Last updated
07/11/2022
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