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General NPI Number Information
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NPI Number | 1750256855
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Entity Type | Organization
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Legal Business Name | AXON MEDICAL GROUP PC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 3824 BARRETT DR STE 101
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City | RALEIGH
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State | NC
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Zip | 27609-7220
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Country | US
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Telephone | 919-275-0785
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Fax |
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Provider Business Mailing Address
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Address Line | 3824 BARRETT DR STE 101
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City | RALEIGH
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State | NC
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Zip | 27609-7220
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Country | US
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Telephone | 919-275-0785
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUMUL MODI
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Credential | MD
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Telephone | 919-275-0785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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