Provider Demographics
NPI:1164429205
Name:CATES, DAPHNE JOAN (MD)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:JOAN
Last Name:CATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 WILKINS DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-7268
Mailing Address - Country:US
Mailing Address - Phone:919-776-6000
Mailing Address - Fax:919-776-0130
Practice Address - Street 1:2412 WILKINS DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330
Practice Address - Country:US
Practice Address - Phone:919-776-6000
Practice Address - Fax:919-776-0130
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2019-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001014335207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134UJMedicaid
NC2023386Medicare ID - Type Unspecified
NC89134UJMedicaid