Healthcare Provider Details

I. General information

NPI: 1952973067
Provider Name (Legal Business Name): KATIE SPENCER TOBIK MGCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

PO BOX 32861
CHARLOTTE NC
28232-2861
US

V. Phone/Fax

Practice location:
  • Phone: 800-698-2411
  • Fax:
Mailing address:
  • Phone: 809-442-5416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: