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General NPI Number Information
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NPI Number | 1013246727
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE CENTER, PA
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 2705 MEDICAL OFFICE PL
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City | GOLDSBORO
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State | NC
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Zip | 27534-9458
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Country | US
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Telephone | 919-731-2526
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Fax | 919-580-0988
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Provider Business Mailing Address
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Address Line | 2705 MEDICAL OFFICE PL
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City | GOLDSBORO
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State | NC
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Zip | 27534-9458
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Country | US
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Telephone | 919-731-2526
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Fax | 919-580-0988
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. VENKATA C MOTAPARTHY
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Credential | MD
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Telephone | 919-731-2126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 25379
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License Number State | NC
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