Provider Demographics
NPI:1609363258
Name:RDMG ASSOCIATES, PA
Entity Type:Organization
Organization Name:RDMG ASSOCIATES, PA
Other - Org Name:HERITAGE URGENT AND PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-233-5956
Mailing Address - Street 1:5420 WADE PARK BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-4189
Mailing Address - Country:US
Mailing Address - Phone:919-233-5952
Mailing Address - Fax:
Practice Address - Street 1:13271 STRICKLAND RD STE 120
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5246
Practice Address - Country:US
Practice Address - Phone:919-741-4677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RDMG ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty