Healthcare Provider Details

I. General information

NPI: 1245595214
Provider Name (Legal Business Name): ATLANTIC REPRODUCTIVE MEDICINE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10208 CERNY ST 306
RALEIGH NC
27617-7884
US

IV. Provider business mailing address

10208 CERNY ST 306
RALEIGH NC
27617-7884
US

V. Phone/Fax

Practice location:
  • Phone: 919-248-8777
  • Fax:
Mailing address:
  • Phone: 919-248-8777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID WALMER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 919-602-8872