Healthcare Provider Details
I. General information
NPI: 1831066208
Provider Name (Legal Business Name): RALEIGH DURHAM MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2414 EMERALD PL
GREENVILLE NC
27834-5784
US
IV. Provider business mailing address
PO BOX 96860
CHARLOTTE NC
28296-6860
US
V. Phone/Fax
- Phone: 252-757-3939
- Fax: 252-757-3973
- Phone: 866-557-2612
- Fax: 919-854-7774
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JING
ZHANG
Title or Position: MD
Credential:
Phone: 919-859-5650