Debnam Clinic Pa | |
524 S Blount St Raleigh NC 27601-1828 | |
(919) 832-1667 | |
Not Available |
Full Name | Debnam Clinic Pa |
---|---|
Speciality | Internal Medicine |
Location | 524 S Blount St, Raleigh, North Carolina |
Authorized Official Name and Position | Marie Georgette Debnam (PRESIDENT) |
Authorized Official Contact | 9198321667 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Debnam Clinic Pa 1501 Poole Rd Raleigh NC 27610-2656 Ph: (919) 832-1667 | Debnam Clinic Pa 524 S Blount St Raleigh NC 27601-1828 Ph: (919) 832-1667 |
NPI Number | 1215143185 |
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Provider Enumeration Date | 05/15/2007 |
Last Update Date | 01/19/2017 |
Medicare PECOS PAC ID | 0648264754 |
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Medicare Enrollment ID | O20040412001510 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215143185 | NPI | - | NPPES |
890197H | Medicaid | NC | |
0197H | Other | NC | BCBSNC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Marie G Debnam |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1205965068 PECOS PAC ID: 2062493778 Enrollment ID: I20040527001311 |
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