Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Oct 3, 2005
License(s)
200601337 (NC), 0101278390 (VA), 89332 (SC), 200601337 (NC), T3734 (TX)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5220 GREENS DAIRY RD | Raleigh, NC 27616-4612 | 919-781-1437 |
| MAILING | 5220 GREENS DAIRY RD | Raleigh, NC 27616-4612 | 919-781-1437 |
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