Healthcare Provider Details

I. General information

NPI: 1245322072
Provider Name (Legal Business Name): VILLAGE FAMILY MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 CONNER DR SUITE 1101
CHAPEL HILL NC
27514-7039
US

IV. Provider business mailing address

109 CONNER DR SUITE 1101
CHAPEL HILL NC
27514-7041
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-4551
  • Fax: 919-929-7405
Mailing address:
  • Phone: 919-968-4551
  • Fax: 919-929-7405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: YVONNE LUYANDO
Title or Position: PRESIDENT
Credential: MD
Phone: 919-968-4551