Healthcare Provider Details

I. General information

NPI: 1841602729
Provider Name (Legal Business Name): ALICIA BARNES CHITANAND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA BARNES DO

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 OLIVE CHAPEL RD STE 124
APEX NC
27502-6766
US

IV. Provider business mailing address

1600 OLIVE CHAPEL RD STE 124
APEX NC
27502-6766
US

V. Phone/Fax

Practice location:
  • Phone: 919-752-4868
  • Fax:
Mailing address:
  • Phone: 919-752-4868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number0102204556
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberFC6870251
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: