| 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 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 01/19/2017 |
| Medicare PECOS PAC ID | 0648264754 |
|---|---|
| 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 | (NU) | Primary |
| Provider Name | Marie G Debnam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205965068 PECOS PAC ID: 2062493778 Enrollment ID: I20040527001311 |
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