Healthcare Provider Details

I. General information

NPI: 1861592644
Provider Name (Legal Business Name): NC CENTER FOR REPRODUCTIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ASHVILLE AVE
CARY NC
27518
US

IV. Provider business mailing address

400 ASHVILLE AVE
CARY NC
27518
US

V. Phone/Fax

Practice location:
  • Phone: 919-233-1680
  • Fax: 919-233-1685
Mailing address:
  • Phone: 919-233-1680
  • Fax: 919-233-1685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: KAMAL S TOMA
Title or Position: MANAGER
Credential:
Phone: 919-233-1680