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Raleigh Durham Medical Group PA — NPI 1912243189, Roxboro, NC | NPI Central

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NPI 1912243189

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Raleigh Durham Medical Group PA

NPI 1912243189 · Non-Pharmacy Dispensing Site · Roxboro, NC

Provider details

NPI number: 1912243189
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Organization subpart: Yes
Authorized official: Kenny Heine, Vp Ops(858) 964-1506
License: 104138 (NC)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense 104138 (NC)
Suppliers

Practice location

107 Weeks Dr

Roxboro, NC 27573-3933

Phone: (336) 598-5480

Approximate (ZIP-level) locationGet directions

More NC providers

Mailing address

5626 Oberlin Dr

San Diego, CA 92121-1705

Other names (DBA / former)

Doing business as: Roxboro Family Medicine

Registry dates

Enumerated: 2012-12-17
Last updated: 2012-12-17

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.