Most Relevant Information
Provider Data
| NPI Number: | 1003514670 |
| Provider Name: | BRENDAN GOLDUP PAC |
| Entity Type: | Individual |
| Taxonomy Code: | 363AS0400X |
| Specialty: | Physician Assistant |
| License Number: | 0010-14215 |
Most Important Dates
| Enumeration Date: | 02/22/2023 |
| Last Updated: | 06/05/2024 |
Provider Practice Location
11221 GALLERIA AVE STE 101
RALEIGH
NC
276148137
Practice Location Phone/Fax
| Phone: | 9195629410 |
| Fax: | 9195629425 |
Provider Mailing Location
PO BOX 1107
WAKE FOREST
NC
275881107
Provider Mailing Phone/Fax
| Phone: | 9195629410 |
| Fax: | 9195629425 |