Provider Demographics
NPI:1831477447
Name:DUKE UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:DUKE UNIVERSITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CF OF SPEECH LANGUAGE PATHOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:SLP-CF
Authorized Official - Phone:919-724-3995
Mailing Address - Street 1:155 BAKER HOUSE TRENT DR
Mailing Address - Street 2:DUMC 3887
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 BAKER HOUSE TRENT DR
Practice Address - Street 2:DUMC 3887
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-668-2734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1205013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty