Provider Demographics
NPI:1942474580
Name:DUKE UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:DUKE UNIVERSITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENCY PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-684-6973
Mailing Address - Street 1:184 WHEELER DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8865
Mailing Address - Country:US
Mailing Address - Phone:919-605-5326
Mailing Address - Fax:
Practice Address - Street 1:1904 TRADD CT
Practice Address - Street 2:DERMATOLOGY ASSOCIATES
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6637
Practice Address - Country:US
Practice Address - Phone:919-605-5326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200301224261QM2500X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No282N00000XHospitalsGeneral Acute Care Hospital