1134575913 NPI number — UNC SCHOOL OF MEDICINE AND HEALTH CARE SYSTEM

Table of content: (NPI 1134575913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134575913 NPI number — UNC SCHOOL OF MEDICINE AND HEALTH CARE SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNC SCHOOL OF MEDICINE AND HEALTH CARE SYSTEM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1134575913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
160 DENTAL CIR
Provider Second Line Business Mailing Address:
ROOM 4032 BURNETT-WOMACK BLDG., CB#7050
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27599-5021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-966-4653
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 DENTAL CIR
Provider Second Line Business Practice Location Address:
ROOM 4032 BURNETT-WOMACK BLDG., CB#7050
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-5021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-4653
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BUNDRANT
Authorized Official First Name:
NIKKIDA
Authorized Official Middle Name:
Authorized Official Title or Position:
GENERAL SURGERY RESIDENT
Authorized Official Telephone Number:
540-840-3769

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  218624 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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