| Mideastern Telemedicine | |
|
4804 Page Creek Ln Ste 115 Durham NC 27703-8582 | |
| (919) 867-4996 | |
| (866) 467-2909 |
| Full Name | Mideastern Telemedicine |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4804 Page Creek Ln Ste 115, Durham, North Carolina |
| Authorized Official Name and Position | Ursula Tomika White (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9198674996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mideastern Telemedicine 4804 Page Creek Ln Ste 115 Durham NC 27703-8582 Ph: (919) 867-4996 | Mideastern Telemedicine 4804 Page Creek Ln Ste 115 Durham NC 27703-8582 Ph: (919) 867-4996 |
| NPI Number | 1407482912 |
|---|---|
| Provider Enumeration Date | 03/16/2020 |
| Last Update Date | 06/17/2023 |
| Medicare PECOS PAC ID | 3678995347 |
|---|---|
| Medicare Enrollment ID | O20200625001566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407482912 | NPI | - | NPPES |
| Provider Name | Ursula Tomika White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912224726 PECOS PAC ID: 5395174759 Enrollment ID: I20200406002182 |
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