| Provider Health Alliance | |
|
1004 Dresser Ct Ste 102 Raleigh NC 27609-7325 | |
| (919) 654-7309 | |
| Not Available |
| Full Name | Provider Health Alliance |
|---|---|
| Speciality | Family Medicine |
| Location | 1004 Dresser Ct Ste 102, Raleigh, North Carolina |
| Authorized Official Name and Position | Sharon Mendenhall (QUALITY / COMPLIANCE MANAGER) |
| Authorized Official Contact | 9196547309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provider Health Alliance 1004 Dresser Ct Ste 102 Raleigh NC 27609-7325 Ph: (919) 654-7309 | Provider Health Alliance 1004 Dresser Ct Ste 102 Raleigh NC 27609-7325 Ph: (919) 654-7309 |
| NPI Number | 1497520654 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497520654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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