Healthcare Provider Details
I. General information
NPI: 1790802106
Provider Name (Legal Business Name): CAROLINA CONCEPTIONS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 LAKE DRIVE SUITE 301
RALEIGH NC
27607
US
IV. Provider business mailing address
2601 LAKE DRIVE SUITE 301
RALEIGH NC
27607
US
V. Phone/Fax
- Phone: 919-782-5911
- Fax: 919-861-6400
- Phone: 919-782-5911
- Fax: 919-861-6400
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
ROBERT
MEYER
Title or Position: PRESIDENT
Credential: MD
Phone: 919-782-5911