Basic Information
| Provider Information | |||||||||
| NPI: | 1679976567 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOCUSMD NC1013 PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 360127 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352360127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8772253542 | ||||||||
| FaxNumber: | 8776389903 | ||||||||
| Practice Location | |||||||||
| Address1: | 4822 SIX FORKS RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276095269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193364244 | ||||||||
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| ProviderEnumerationDate: | 10/06/2014 | ||||||||
| LastUpdateDate: | 10/06/2014 | ||||||||
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| AuthorizedOfficialLastName: | NEEL | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9193364244 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.