Healthcare Provider Details

I. General information

NPI: 1679976567
Provider Name (Legal Business Name): FOCUSMD NC1013 PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4822 SIX FORKS RD STE 102
RALEIGH NC
27609-5269
US

IV. Provider business mailing address

PO BOX 360127
BIRMINGHAM AL
35236-0127
US

V. Phone/Fax

Practice location:
  • Phone: 919-336-4244
  • Fax:
Mailing address:
  • Phone: 877-225-3542
  • Fax: 877-638-9903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH NEEL
Title or Position: OWNER
Credential: MD
Phone: 919-336-4244