The Longevity Doctor, PLLC
Family Medicine in Raleigh, NC. Organization (NPI-2).
NPI number1497500441
StatusActive
Last updated in NPPESApr 23, 2024
Details
- NPI
- 1497500441
- Entity type
- Organization (NPI-2)
- Legal business name
- The Longevity Doctor, PLLC
- Organization subpart
- No
- Enumeration date
- Apr 23, 2024
- Certification date
- Apr 18, 2024
- Last updated
- Apr 23, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
2810 Wakefield Pines Dr Ste 115Raleigh, NC 27614-7078
Phone 919-417-3740
Mailing address
2810 Wakefield Pines Dr Ste 115Raleigh, NC 27614-7078
Authorized official
Octavian M. Belcea
Manager
9194173740
Is something wrong?
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