Healthcare Provider Details

I. General information

NPI: 1770942005
Provider Name (Legal Business Name): CAROLINA WOMEN S RESEARCH AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016
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

4020 WESTCHASE BLVD SUITE 475
RALEIGH NC
27607-3938
US

V. Phone/Fax

Practice location:
  • Phone: 919-251-9223
  • Fax: 919-251-9343
Mailing address:
  • Phone: 919-334-0150
  • Fax: 10-334-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHELIA M BALDWIN
Title or Position: DIRECTOR
Credential:
Phone: 919-334-0150