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NPI Code Detail

MEDICARE: RALEIGH DURHAM MEDICAL GROUP, PA

MEDICARE: RALEIGH DURHAM MEDICAL GROUP, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
2363L00000XNurse Practitioner
3363A00000XPhysician Assistant
4207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1013371061
Entity Type Code : Organization
Provider Name (Legal Business Name) : RALEIGH DURHAM MEDICAL GROUP, PA
Provider Business Mailing Address
First Line : PO BOX 96860
Second Line :
City : CHARLOTTE
State : NC
Zip : 28296-6860
Country : US
Telephone Number : 919-233-5952
Fax Number : 312-324-7850
Provider Business Practice Location Address
First Line : 236 BUTTERNUT LN
Second Line :
City : CLAYTON
State : NC
Zip : 27520-5857
Country : US
Telephone Number : 919-359-1011
Fax Number : 919-359-9122
Authorized Official
Title or Position : CEO
Name : DAVID MOYE
Credential :
Telephone Number : 919-614-0301
Provider Enumeration Date : 04/06/2016
Last Update Date : 11/04/2025

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