| Duke Health Integrated Practice, Inc | |
|
10207 Cerny St Ste 210 Raleigh NC 27617-4887 | |
| (800) 266-3853 | |
| Not Available |
| Full Name | Duke Health Integrated Practice, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10207 Cerny St Ste 210, Raleigh, North Carolina |
| Authorized Official Name and Position | John Stuart Smith (VP FINANCE) |
| Authorized Official Contact | 9196138995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duke Health Integrated Practice, Inc Po Box 110566 Durham NC 27709-5566 Ph: (919) 620-4855 | Duke Health Integrated Practice, Inc 10207 Cerny St Ste 210 Raleigh NC 27617-4887 Ph: (800) 266-3853 |
| NPI Number | 1740978386 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 09/12/2023 |
| Medicare PECOS PAC ID | 8325412737 |
|---|---|
| Medicare Enrollment ID | O20240122004118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740978386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Primary |
| Provider Name | Carrie Marie Peterson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013996727 PECOS PAC ID: 0345291092 Enrollment ID: I20210817003454 |
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