Healthcare Provider Details

I. General information

NPI: 1205769825
Provider Name (Legal Business Name): VERITAS PRIVATE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 N MAIN ST STE E
RAEFORD NC
28376-2861
US

IV. Provider business mailing address

123 N MAIN ST STE E
RAEFORD NC
28376-2861
US

V. Phone/Fax

Practice location:
  • Phone: 910-585-3900
  • Fax:
Mailing address:
  • Phone: 910-585-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE MACKLIN
Title or Position: PHYSICIAN ASSISTANT
Credential:
Phone: 910-710-3783