Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Parent organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Other names
Duke Sports Medicine Green Level
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIVATE DIAGNOSTIC CLINIC, PLLC
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
100 DUKE HEALTH CARY PLACE, SUITE 120, CARY, NC 27519
(919) 385-8120
(919) 385-9500
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
04/05/2022
Last updated
05/17/2022
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