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SOUTHWEST DURHAM FAMILY MEDICINE PLLC NPI 1295706133


NPI Information

NPI: 1295706133
Provider Name: SOUTHWEST DURHAM FAMILY MEDICINE, PLLC

Doing Business As: SW DURHAM FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 34D1034854

Address:
1515 W NC HWY 54
STE 130
DURHAM, NC
ZIP 27707
Phone: (919) 419-0242
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SOUTHWEST DURHAM FAMILY MEDICINE, PLLC is a family medicine in Durham, NC. The provider is 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. SOUTHWEST DURHAM FAMILY MEDICINE, PLLC NPI is 1295706133. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sw Durham Family Medicine.

The provider's business location address is:

1515 W NC HWY 54
STE 130
DURHAM, NC
ZIP 27707
Phone: (919) 419-0242
Fax: (919) 401-4172

The provider's authorized official is Tiffany Marum .
The authorized official title is Managing Physician and has the following contact phone number (919) 419-0242.

The CLIA number assigned to this NPI record is 34D1034854 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2006 and was last updated on 9/21/2022.


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
1207R00000XInternal Medicine9700021NORTH CAROLINANo
2207Q00000XFamily Medicine200300258NORTH CAROLINAYes

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
1017RTOTHERNORTH CAROLINABLUE CROSS BLUE SHIELD

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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