PRIVATE DIAGNOSTIC CLINIC PLLC NPI 1235459926

NPI Information

  • NPI: 1235459926
  • Provider Name: PRIVATE DIAGNOSTIC CLINIC, PLLC
  • Classification: Internal Medicine - 207RH0003X
  • Specialization: Hematology & Oncology
  • Entity Type: Organization
  • Doing Business As: SOUTHEASTERN CANCER-PEMBROKE
  • Address: 812 CANDY PARK RD
    PEMBROKE, NC
    ZIP 28372
  • Phone: (910) 671-5730

Map and Directions

Get Directions

NPI Details

PRIVATE DIAGNOSTIC CLINIC, PLLC is a hematology and oncology internal medicine in Pembroke, NC. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. PRIVATE DIAGNOSTIC CLINIC, PLLC NPI is 1235459926. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southeastern Cancer-pembroke.

The provider's business location address is:

812 CANDY PARK RD
PEMBROKE, NC
ZIP 28372-129
Phone: (910) 671-5730

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 enumeration date for this NPI number is 6/4/2010 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI