Healthcare Provider Details

I. General information

NPI: 1548374523
Provider Name (Legal Business Name): PLANNED PARENTHOOD SOUTH ATLANTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 NEWSOM ST STE 101
DURHAM NC
27704-2197
US

IV. Provider business mailing address

100 S BOYLAN AVE
RALEIGH NC
27603-1802
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-2872
  • Fax: 919-433-0360
Mailing address:
  • Phone: 919-833-7526
  • Fax: 919-390-1384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number05376
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: KARL LEVILLE
Title or Position: CFO
Credential:
Phone: 919-833-7526