Provider Demographics
NPI:1699558742
Name:CAPITAL PRIMARY CARE
Entity type:Organization
Organization Name:CAPITAL PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:KONDURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-870-0197
Mailing Address - Street 1:203 MICHELANGELO WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8716
Mailing Address - Country:US
Mailing Address - Phone:919-870-0197
Mailing Address - Fax:919-870-0265
Practice Address - Street 1:10640 DURANT RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6566
Practice Address - Country:US
Practice Address - Phone:919-870-0197
Practice Address - Fax:919-870-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty