Organization
DUKE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARISA P GAVRILOVA-JORDAN M.D. (REF FELLOW PHYSICIAN)
(619) 807-2953
Entity
Organization
Contact information
Practice address
5704 FAYETTEVILLE RD, DURHAM, NC 27713-9089
(619) 807-2953
Mailing address
5438 ECHO RIDGE RD, RALEIGH, NC 27612-6949
(619) 807-2953
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NC
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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