Healthcare Provider Details

I. General information

NPI: 1588195309
Provider Name (Legal Business Name): RDMG ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5059 HWY 70 W
MOREHEAD CITY NC
28557-4503
US

IV. Provider business mailing address

5420 WADE PARK BLVD STE 106
RALEIGH NC
27607-4188
US

V. Phone/Fax

Practice location:
  • Phone: 252-808-3696
  • Fax: 252-808-2022
Mailing address:
  • Phone: 919-233-5952
  • Fax: 919-854-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DAVID MOYE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-233-5952