Healthcare Provider Details

I. General information

NPI: 1497750939
Provider Name (Legal Business Name): DURHAM INTERNAL MEDICINE ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 BEN FRANKLIN BLVD DBA DURHAM INTERNAL MEDICINE ASSOCIATES
DURHAM NC
27704-2143
US

IV. Provider business mailing address

4205 BEN FRANKLIN BLVD
DURHAM NC
27704-2143
US

V. Phone/Fax

Practice location:
  • Phone: 919-477-6900
  • Fax: 919-477-5081
Mailing address:
  • Phone: 919-477-6900
  • Fax: 919-477-5081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number207R00000X
License Number StateNC

VIII. Authorized Official

Name: DR. WILLIAM VANCE SINGLETARY JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 919-477-6900