Healthcare Provider Details

I. General information

NPI: 1174160923
Provider Name (Legal Business Name): NEWELL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 11/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10208 CERNY ST STE 308
RALEIGH NC
27617-7885
US

IV. Provider business mailing address

8311 BRIER CREEK PKWY STE 105320
RALEIGH NC
27617-7328
US

V. Phone/Fax

Practice location:
  • Phone: 919-641-0314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUDY BRANGMAN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 919-641-0314