Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Jul 5, 2011
License(s)
30732 (WV), 2016-00901 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 6303 WINDING ARCH DR | Durham, NC 27713-6409 | 734-431-1764 |
| LOCATION | 509 N BRIGHTLEAF BLVD | Smithfield, NC 27577-4407 | 919-938-7189 |
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