Healthcare Provider Details

I. General information

NPI: 1174733943
Provider Name (Legal Business Name): CLAIRE VAN EENWYK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAIRE VAN EENWYK CHEHRAZI MD

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 05/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6013 FARRINGTON RD SUITE 301
CHAPEL HILL NC
27517-8172
US

IV. Provider business mailing address

2520 MERIDIAN PKWY SUITE 200
DURHAM NC
27713-4202
US

V. Phone/Fax

Practice location:
  • Phone: 919-962-4824
  • Fax:
Mailing address:
  • Phone: 919-666-4743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number2009-00392
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: