Healthcare Provider Details

I. General information

NPI: 1356835268
Provider Name (Legal Business Name): AMN MEDICAL GROUP II PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 CREEKSIDE LANDING DR
APEX NC
27502-3982
US

IV. Provider business mailing address

2034 CREEKSIDE LANDING DR
APEX NC
27502-3982
US

V. Phone/Fax

Practice location:
  • Phone: 919-363-8011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number2012-02254
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ALAN NADOUR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 919-363-8011