Healthcare Provider Details

I. General information

NPI: 1336494178
Provider Name (Legal Business Name): DUKE UNIVERSITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN ROAD ADVANCE CLINICAL PRACTICE-NICU
DURHAM NC
27710-2739
US

IV. Provider business mailing address

DUMC BOX# 2739 MEDICAL CENTER ADVANCE CLINICAL PRACTICE-NICU
DURHAM NC
27715-2739
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-6024
  • Fax:
Mailing address:
  • Phone: 919-681-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. ROBERT W LENFESTEY
Title or Position: NEONATOLOGIST
Credential: MD, MHS
Phone: 919-668-1592