Provider Demographics
NPI:1023046042
Name:DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC.
Entity Type:Organization
Organization Name:DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC.
Other - Org Name:DURHAM MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-416-8103
Mailing Address - Street 1:PO BOX 110566
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-5566
Mailing Address - Country:US
Mailing Address - Phone:919-620-4855
Mailing Address - Fax:919-620-4921
Practice Address - Street 1:4220 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1826
Practice Address - Country:US
Practice Address - Phone:919-471-1518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-29
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0173MOtherBCBS GROUP NUMBER
NCCD6390Medicare PIN
NC2317755KMedicare PIN