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General NPI Number Information
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NPI Number | 1295612505
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Entity Type | Organization
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Legal Business Name | RALEIGH NEUROSURGICAL CLINIC, INC.
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 12610 N COMMUNITY HOUSE RD STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28277-4137
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Country | US
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Telephone | 919-785-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 5241 SIX FORKS RD STE 100
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City | RALEIGH
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State | NC
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Zip | 27609-4431
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Country | US
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Telephone | 919-277-9839
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JACOB A RODMAN
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Credential |
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Telephone | 919-785-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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