MEDICARE: RDMG ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1063953602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RDMG ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 96860
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28296-6860
Country	:	US
Telephone Number	:	919-233-5952
Fax Number	:	312-324-7850

Provider Business Practice Location Address
First Line	:	6419 CAROLINA BEACH RD
Second Line	:	SUITE A
City	:	WILMINGTON
State	:	NC
Zip	:	28412-3671
Country	:	US
Telephone Number	:	910-790-3660
Fax Number	:	910-790-9499

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DAVID MOYE
Credential	:
Telephone Number	:	919-614-0301

Provider Enumeration Date	:	03/15/2017
Last Update Date	:	11/04/2025

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