Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Vistar Medical Clinic PA

Organization Internal Medicine Physician · NPI 1730260134

Vistar Medical Clinic PA is an Internal Medicine Physician in Raleigh, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1004 Bullard Ct Ste 101
Raleigh, NC 27615-6853
Phone: (919) 255-3511
Fax: (888) 249-0062
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 94-00118 (NC)

Record details

NPI number1730260134
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maximus Onuoha — Chairman & Ceo · (919) 255-3511
NPI enumeratedOctober 18, 2006
Last updated in NPPESFebruary 13, 2020
Certification dateFebruary 13, 2020
Mailing addressPo Box 40028, Raleigh, NC 27629-0028

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