Organization
PRIVATE DIAGNOSTIC CLINIC, PLLC
Active
Other names
Duke Eye Winston Salem
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization
Contact information
Practice address
2025 FRONTIS PLAZA BLVD, SUITE 100, WINSTON SALEM, NC 27103-5663
(336) 768-3240
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8902034
—
NC
Enumeration date
09/20/2006
Last updated
07/11/2022
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