Provider Demographics
NPI:1073575668
Name:SALEEBY, RICHARD G JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:SALEEBY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 BLUE RIDGE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6695
Mailing Address - Country:US
Mailing Address - Phone:919-787-2542
Mailing Address - Fax:
Practice Address - Street 1:2406 BLUE RIDGE RD STE 250
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6695
Practice Address - Country:US
Practice Address - Phone:919-787-2542
Practice Address - Fax:919-783-8225
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29502208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC014TWOtherBCBS NC
NCD42045Medicare UPIN
NC014TWOtherBCBS NC