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Organization

MAGNOLIA MEDICINE DPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHANNA HADLEY SAMPSON MD (PHYSICIAN OWNER)
(317) 697-8490
Entity
Organization

Contact information

Practice address
600 WADE AVE STE A, RALEIGH, NC 27605-3121
(919) 228-8155
(984) 220-9276
Mailing address
600 WADE AVE STE A, RALEIGH, NC 27605-3121
(919) 228-8155
(984) 220-9276

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
10/13/2025
Last updated
10/13/2025
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