MEDICARE: RDMG ASSOCIATES PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1588115752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RDMG ASSOCIATES PA

Provider Business Mailing Address
First Line	:	PO BOX 63103
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28263-3103
Country	:	US
Telephone Number	:	919-233-5952
Fax Number	:	312-324-7850

Provider Business Practice Location Address
First Line	:	620 DR CALVIN JONES HWY
Second Line	:	STE 212
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-3100
Country	:	US
Telephone Number	:	919-761-5678
Fax Number	:	919-761-5680

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DAVID MOYE
Credential	:
Telephone Number	:	919-614-0301

Provider Enumeration Date	:	10/21/2016
Last Update Date	:	09/04/2024

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Directions to “RDMG ASSOCIATES PA ” Practice Location

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