Healthcare Provider Details

I. General information

NPI: 1528454980
Provider Name (Legal Business Name): PHILLIP SHOLES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF ANESTHESIOLOGY N2198, CB7010, UNC HOSPITALS
CHAPEL HILL NC
27599-7010
US

IV. Provider business mailing address

DEPARTMENT OF ANESTHESIOLOGY N2198, CB7010, UNC HOSPITALS
CHAPEL HILL NC
27599-7010
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-8654
  • Fax:
Mailing address:
  • Phone: 850-339-4414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberMD.36314
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number29533
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number265734
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: