Basic Information
| Provider Information | |||||||||
| NPI: | 1205943073 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RALEIGH ORTHOPAEDIC CLINIC PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3515 GLENWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276124934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197815600 | ||||||||
| FaxNumber: | 9197826578 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 ASHVILLE AVE | ||||||||
| Address2: | SUITE 20 | ||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275116130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197815600 | ||||||||
| FaxNumber: | 9197826578 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | STEIN | ||||||||
| AuthorizedOfficialFirstName: | KARL | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9197815600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.