| Direct Medical Xperience | |
|
4505 Fair Meadows Ln Ste 215 Raleigh NC 27607-6449 | |
| (919) 944-9935 | |
| Not Available |
| Full Name | Direct Medical Xperience |
|---|---|
| Speciality | Clinic/Center |
| Location | 4505 Fair Meadows Ln Ste 215, Raleigh, North Carolina |
| Authorized Official Name and Position | Deaundre Alfonzo Dyer (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9199449935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Direct Medical Xperience 11845 Retail Dr # 1079 Wake Forest NC 27587-7352 Ph: (919) 944-9935 | Direct Medical Xperience 4505 Fair Meadows Ln Ste 215 Raleigh NC 27607-6449 Ph: (919) 944-9935 |
| NPI Number | 1285341834 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 11/18/2024 |
| Medicare PECOS PAC ID | 8729516133 |
|---|---|
| Medicare Enrollment ID | O20250114000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285341834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Deaundre Alfonzo Dyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215427018 PECOS PAC ID: 5991060220 Enrollment ID: I20220609000290 |
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