Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Duke Children's Cardiology of Charlotte
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
1718 E 4TH ST, SUITE 304, CHARLOTTE, NC 28204-3261
(704) 316-1220
(704) 316-1230
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Enumeration date
04/20/2011
Last updated
07/11/2022
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