Individual
JUDITH YEN LIN COLCLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6905 KNIGHTDALE BLVD STE 106, KNIGHTDALE, NC 27545-6506
(919) 261-8760
(919) 261-8765
Mailing address
2000 PERIMETER PARK DR STE 200, MORRISVILLE, NC 27560-8442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200401649
NC
207Q00000X
Family Medicine Physician
237887
MA
207Q00000X
Family Medicine Physician
3811
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110080968A
—
MA
Enumeration date
05/18/2006
Last updated
05/06/2021
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