Organization
GOLDSBORO MEDICAL CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUIN M DUGOM M.D. (PRESIDENT)
(919) 739-9599
Entity
Organization
Contact information
Practice address
2400 WAYNE MEMORIAL DR, SUITE J, GOLDSBORO, NC 27534-1789
(919) 739-9599
(919) 739-5535
Mailing address
2400 WAYNE MEMORIAL DR, SUITE J, GOLDSBORO, NC 27534-1749
(919) 739-9599
(919) 739-5535
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
9600902
NC
207R00000X
Internal Medicine Physician
Primary
9600902
NC
208D00000X
General Practice Physician
9600902
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147TC
BLUE CROSS BLUE SHIELD
NC
01
—
29352
BLUE CROSS
NC
01
—
562122497
TAX ID#
NC
05
—
8929352
—
NC
Enumeration date
02/08/2008
Last updated
02/01/2012
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