Organization · Type 2 NPI

Raleigh Durham Medical Group, PA

Family Medicine Physician · Shallotte, NC

NPI number 1720458326 Active

Practice location

4748 Main Street
Shallotte, NC 28470

Call (910) 754-2273 Map

Fax (910) 754-2254

Mailing address

5420 Wade Park Blvd, Ste 106
Raleigh, NC 27607-4188

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Family Nurse Practitioner	363LF0000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

Other family medicine physician providers in Shallotte

See all in Shallotte →

NPI record

NPI: 1720458326
Entity type: Organization (Type 2)
Issued: Sep 25, 2015
Last updated: Apr 1, 2016
Status: Active
Subpart: Yes of Raleigh Durham Medical Group, PA

Other names

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Seaside Wellness of Shallotte · doing business as

Authorized official

David K. Moye
Executive Director
(919) 233-5956

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1720458326

Raleigh Durham Medical Group, PA's National Provider Identifier is 1720458326, issued on Sep 25, 2015. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Shallotte, NC. The record was last updated on Apr 1, 2016.