Organization
RALEIGH ADULT MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA HOGAN (PRACTICE ADMINISTRATOR)
(919) 781-9979
Entity
Organization
Contact information
Practice address
3200 BLUE RIDGE RD, STE 210, RALEIGH, NC 27612-8086
(919) 781-9979
(919) 781-0124
Mailing address
3200 BLUE RIDGE RD, STE 210, RALEIGH, NC 27612-8086
(919) 781-9979
(919) 781-0124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02360
BCBS NC GROUP NUMBER
NC
05
—
5902360
—
NC
Enumeration date
06/15/2006
Last updated
08/22/2020
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