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Individual

DR. VICTOR A. MEDINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
115 CRESCENT COMMONS DR, SUITE 200, CARY, NC 27518-8102
(919) 851-5055
(919) 851-3065
Mailing address
115 CRESCENT COMMONS DR, SUITE 200, CARY, NC 27518-8102
(919) 851-5055
(919) 851-3065

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
32145
NC
2086S0129X
Vascular Surgery Physician
Primary
32145
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020014831
MEDICARE RR
NC
01
58459
BCBSNC
NC
05
8958459
NC
Enumeration date
01/11/2007
Last updated
08/11/2010
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