Healthcare Provider Details

I. General information

NPI: 1730590738
Provider Name (Legal Business Name): DEMETRIA BUIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S POINT RD STE A
BELMONT NC
28012-9791
US

IV. Provider business mailing address

8522 SIX FORKS RD 102
RALEIGH NC
27615-3097
US

V. Phone/Fax

Practice location:
  • Phone: 919-343-8633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018802
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: