Healthcare Provider Details

I. General information

NPI: 1720251275
Provider Name (Legal Business Name): DURHAM VAMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUKE UNIVERSITY MEDICAL CENTER ERWIN RD
DURHAM NC
27710-0001
US

IV. Provider business mailing address

DUKE UNIVERSITY MEDICAL CENTER PO BOX 31035
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax:
Mailing address:
  • Phone: 919-286-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. NADIA BENNETT
Title or Position: DOCTOR
Credential: M.D.
Phone: 443-854-3706