Healthcare Provider Details

I. General information

NPI: 1740483791
Provider Name (Legal Business Name): CAROLINA WOMEN S RESEARCH AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 E NC HIGHWAY 54 SUITE 330
DURHAM NC
27713-7512
US

IV. Provider business mailing address

PO BOX 61721
DURHAM NC
27715-1721
US

V. Phone/Fax

Practice location:
  • Phone: 919-251-9223
  • Fax: 919-251-9343
Mailing address:
  • Phone: 919-544-6318
  • Fax: 919-544-6336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREA S LUKES
Title or Position: PRESIDENT
Credential: MD
Phone: 919-251-9223