Healthcare Provider Details

I. General information

NPI: 1790064830
Provider Name (Legal Business Name): UNC PHYSICIANS NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W WILLIAMS ST SUITE #200
APEX NC
27502-5203
US

IV. Provider business mailing address

1600 PERIMETER PARK DR SUITE #225
MORRISVILLE NC
27560-8421
US

V. Phone/Fax

Practice location:
  • Phone: 919-363-9363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier5918696
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: DR. ROBERT L GIANFORCARO
Title or Position: DIRECTOR
Credential: DO
Phone: 919-923-0660