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NPI 1447844162

NPI 1447844162 : NORTH RALEIGH INTEGRATED PRIMARY CARE PLLC : RALEIGH, NC

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General NPI Number Information
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    NPI Number           |    1447844162
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTH RALEIGH INTEGRATED PRIMARY CARE PLLC 
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Dates
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    Enumeration Date     |    02/23/2021
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    Last Update Date     |    12/09/2025
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Provider Practice Location Address
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    Address Line         |    4040 BARRETT DR 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27609-6640
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    Country              |    US
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    Telephone            |    919-689-1010
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4040 BARRETT DR 
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27609-6640
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    Country              |    US
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    Telephone            |    919-689-1010
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PM
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    Name                 |     TRESHELL  HERNDON 
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    Credential           |    
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    Telephone            |    919-689-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207QA0505X
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    Taxonomy Name        |    Adult Medicine Physician
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    License Number       |    
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    License Number State |    
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