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Individual

IMA UDOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
2301 ERWIN RD, DUMC 3935, DUKE NORTH, ROOM 0681, DURHAM, NC 27710-0001
(919) 681-2247
Mailing address
4904 MILLER DR, DURHAM, NC 27704-1870
(917) 304-7864

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/11/2008
Last updated
06/11/2008
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