Provider Demographics
NPI:1235313727
Name:DOWNTOWN HEALTH CENTER
Entity Type:Organization
Organization Name:DOWNTOWN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINGO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-CUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-789-4111
Mailing Address - Street 1:105B S SMITHWICK ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2433
Mailing Address - Country:US
Mailing Address - Phone:252-789-4111
Mailing Address - Fax:252-789-4163
Practice Address - Street 1:105B S SMITHWICK ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2433
Practice Address - Country:US
Practice Address - Phone:252-789-4111
Practice Address - Fax:252-789-4163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty