Healthcare Provider Details

I. General information

NPI: 1780977694
Provider Name (Legal Business Name): EMILY BETH VANDER SCHAAF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 MACNIDER CB 7225
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

231 MACNIDER
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-1505
  • Fax: 919-966-3852
Mailing address:
  • Phone: 919-966-1505
  • Fax: 919-966-7490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number173581
License Number StateNC

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: