1598081986 NPI number — CORAL XANTIA GIOVACCHINI M.D.

Table of content: CORAL XANTIA GIOVACCHINI M.D. (NPI 1598081986)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598081986 NPI number — CORAL XANTIA GIOVACCHINI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIOVACCHINI
Provider First Name:
CORAL
Provider Middle Name:
XANTIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAY
Provider Other First Name:
CORAL
Provider Other Middle Name:
XANTIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598081986
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DUMC BOX 3182, DEPT OF MEDICINE
Provider Second Line Business Mailing Address:
MEDICAL RESIDENCY EDUCATION OFFICE
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27705-1666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-681-2382
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 ERWIN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-684-8111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , with the licence number: 165091(RTL) , 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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