Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
North Carolina Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
4309 MEDICAL PARK DR, DURHAM, NC 27704-2388
(919) 471-9622
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230581
MCA GRP. #
NC
Enumeration date
08/16/2007
Last updated
07/11/2022
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