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PRIVATE DIAGNOSTIC CLINIC PLLC NPI 1235162314


NPI Information

NPI: 1235162314
Provider Name: PRIVATE DIAGNOSTIC CLINIC, PLLC

Doing Business As: DUKE UROLOGY OF RALEIGH

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 34D2026351

Address:
3404 WAKE FOREST RD
SUITE 302
RALEIGH, NC
ZIP 27609
Phone: (919) 684-8111
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PRIVATE DIAGNOSTIC CLINIC, PLLC is an urology in Raleigh, NC. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. PRIVATE DIAGNOSTIC CLINIC, PLLC NPI is 1235162314. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Duke Urology Of Raleigh.

The provider's business location address is:

3404 WAKE FOREST RD
SUITE 302
RALEIGH, NC
ZIP 27609-340
Phone: (919) 684-8111

The provider's authorized official is Christopher Thomas Frederick .
The authorized official title is Cfo and has the following contact phone number (919) 613-7762.

The CLIA number assigned to this NPI record is 34D2026351 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 5/15/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic SurgeryNo
2208800000XUrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17907025MEDICAIDNORTH CAROLINA
207020OTHERNORTH CAROLINAGRP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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