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Organization

RALEIGH DURHAM MEDICAL GROUP, PA

Active
Parent organization
RALEIGH DURHAM MEDICAL GROUP, PA
Other names
NC Pediatric Orthopaedics, Sports & Spine
Organization subpart
Yes

Provider details

NPI number
Legal business name
RALEIGH DURHAM MEDICAL GROUP, PA
Authorized official
DAVID MOYE (EXECUTIVE DIRECTOR)
(919) 851-2174
Entity
Organization

Contact information

Practice address
4301 LAKE BOONE TRL, SUITE 205, RALEIGH, NC 27607-7507
(919) 233-5952
Mailing address
5420 WADE PARK BLVD, SUITE 106, RALEIGH, NC 27607-4188
(919) 233-5952

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary

Other

Enumeration date
12/11/2013
Last updated
12/11/2013
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