Provider Demographics
NPI:1477344992
Name:VYBEMED DIRECT PRIMARY CARE, PLLC
Entity type:Organization
Organization Name:VYBEMED DIRECT PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE-JACQUES
Authorized Official - Middle Name:MARILYN
Authorized Official - Last Name:AMBROISE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:704-743-4371
Mailing Address - Street 1:PO BOX 2757
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-2757
Mailing Address - Country:US
Mailing Address - Phone:704-743-4371
Mailing Address - Fax:
Practice Address - Street 1:11 UNION ST S STE 102
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1001
Practice Address - Country:US
Practice Address - Phone:704-743-4371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty