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General NPI Number Information
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NPI Number | 1689790081
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Entity Type | Organization
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Legal Business Name | RALEIGH FAMILY HEALTH CARE
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3400 EXECUTIVE DR SUITE 201
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City | RALEIGH
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State | NC
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Zip | 27609-7476
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Country | US
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Telephone | 919-875-0504
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Fax | 919-875-0905
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Provider Business Mailing Address
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Address Line | 3400 EXECUTIVE DR SUITE 201
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City | RALEIGH
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State | NC
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Zip | 27609-7476
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Country | US
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Telephone | 919-875-0504
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Fax | 919-875-0905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORRAINE FAITH BIRMINGHAM
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Credential | MD
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Telephone | 919-875-0504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 27773
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License Number State | NC
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