is a Sports Medicine in Raleigh, North Carolina. practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for is 1033160643. The last update date is .
's current location address is 5400 Trinity Rd, Raleigh, North Carolina. You can contact this provider via phone number 9198512174 and fax number 9198547774. The mailing address for is 5400 Trinity Rd, Raleigh, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 5400 Trinity Rd, Raleigh, North Carolina |
| Phone Number | 9198512174 |
| Fax Number | 9198547774 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1033160643 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 5400 Trinity Rd |
|---|---|
| City | Raleigh |
| State | North Carolina (NC) |
| Post Code | 276076001 |
| Phone Number | 9198512174 |
| Fax Number | 9198547774 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Qs0010X |
|
Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 014RU | NC | BCBS |
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