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SOUTHEASTERN CANCER-PEMBROKE
NPI 1235459926
Internal Medicine - Hematology & Oncology in Pembroke, NC

Active since June 04, 2010
812 CANDY PARK RD, PEMBROKE, NC 28372(910) 671-5730 Get Directions Write a Review

NPPES record last updated: May 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southeastern Cancer-pembroke NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN CANCER-PEMBROKE (NPI 1235459926) is a healthcare organization registered as a hematology & oncology in Pembroke, North Carolina and active in the NPI registry since June 2010. The organization lists Christopher Thomas Frederick, Cfo, as its authorized official.

NPPES Registry Identity

NPI1235459926
Entity TypeOrganization
Primary Taxonomy207RH0003X
Legal Business NamePRIVATE DIAGNOSTIC CLINIC, PLLC
Location Address812 CANDY PARK RDPembroke, NC 28372-9129
Mailing AddressPo Box 110566Durham, NC 27709-5566 · (919) 620-4855 · Fax (919) 620-4921
Phone(910) 671-5730
Organization SubpartNo
Authorized OfficialChristopher Thomas FrederickCfo · (919) 613-7762
Enumeration DateJune 4, 2010
Last NPPES UpdateMay 15, 2022
NPPES CertifiedMay 15, 2022
✔ NPI 1235459926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
812 CANDY PARK RD, Pembroke, NC 28372
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Other Names 1

Doing Business AsSoutheastern Cancer-pembroke

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

INTEGRATED PAIN & INJURY CENTER, PLLC
General Practice
812 CANDY PARK RD, SUITE 6103
PEMBROKE, NC 28372
Robeson County (910) 521-3093
PRIVATE DIAGNOSTIC CLINIC, PLLC
Internal Medicine (Cardiovascular Disease)
812 CANDY PARK RD
PEMBROKE, NC 28372
Robeson County (910) 671-6619
DR. JOHN ASHLEY DEESE DC
Chiropractor
812 CANDY PARK RD, SUITE 6103
PEMBROKE, NC 28372
Robeson County (910) 521-3093
HANNA ELIZABETH BULLARD PA-C
Physician Assistant
812 CANDY PARK RD
PEMBROKE, NC 28372
Robeson County (910) 521-0201
KAYLA JACOBS
Physician Assistant
812 CANDY PARK RD
PEMBROKE, NC 28372
Robeson County (910) 521-0201
MS. TRISHA LYNN CARTER LCSW
Social Worker (Clinical)
812 CANDY PARK RD
PEMBROKE, NC 28372
Robeson County (910) 521-0201
GINGER NICHOLE LOCKLEAR MD
Pediatrics
812 CANDY PARK RD
PEMBROKE, NC 28372
Robeson County (910) 521-0201
MR. DAVID A HURLEY RT(R)
Radiologic Technologist (Radiography)
812 CANDY PARK RD, SUITE 7101-C
PEMBROKE, NC 28372
Robeson County (910) 522-0470

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Private Diagnostic Clinic, PLLC's NPI number?

The NPI number for Private Diagnostic Clinic, PLLC is 1235459926. It was assigned to this organization in the NPPES registry on June 4, 2010. The provider is doing business as Southeastern Cancer-Pembroke.

Where is Private Diagnostic Clinic, PLLC located?

Private Diagnostic Clinic, PLLC is located at 812 Candy Park Rd, Pembroke, NC 28372. The listed phone number is (910) 671-5730.

What is Private Diagnostic Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

When was this NPI record last updated?

The NPPES record for Private Diagnostic Clinic, PLLC was last updated on May 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.