| Psychiatry Erwin Square | |
|
2200 W Main St Ste 340 Durham NC 27705-4640 | |
| (919) 416-3439 | |
| Not Available |
| Full Name | Psychiatry Erwin Square |
|---|---|
| Speciality | Psychologist |
| Location | 2200 W Main St, Durham, North Carolina |
| Authorized Official Name and Position | Christopher T Frederick (CFO) |
| Authorized Official Contact | 9196204918 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatry Erwin Square Po Box 110566 Durham NC 27709-5566 Ph: (919) 620-4855 | Psychiatry Erwin Square 2200 W Main St Ste 340 Durham NC 27705-4640 Ph: (919) 416-3439 |
| NPI Number | 1093265241 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 05/13/2022 |
| Certification Date | 05/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093265241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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