Basic Information
| Provider Information | |||||||||
| NPI: | 1689625139 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'LOUGHLIN | ||||||||
| FirstName: | COLM | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2417 ATRIUM DR | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197912040 | ||||||||
| FaxNumber: | 9197912041 | ||||||||
| Practice Location | |||||||||
| Address1: | 2417 ATRIUM DR | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197912040 | ||||||||
| FaxNumber: | 9197912041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 06/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 2007-00290 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.