Provider Demographics
NPI:1407024110
Name:DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC.
Entity Type:Organization
Organization Name:DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC.
Other - Org Name:DUKE PRIMARY CARE CREEDMOOR ROAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISIONAL COO
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:919-668-6008
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 1:7200 CREEDMOOR ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613
Practice Address - Country:US
Practice Address - Phone:919-327-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2317755VMedicare PIN