Healthcare Provider Details

I. General information

NPI: 1144247883
Provider Name (Legal Business Name): ALAN SPANOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 E FRANKLIN ST BUILDING 200A
CHAPEL HILL NC
27514-5861
US

IV. Provider business mailing address

1829 E FRANKLIN ST BUILDING 200A
CHAPEL HILL NC
27514-5861
US

V. Phone/Fax

Practice location:
  • Phone: 919-967-2927
  • Fax: 919-967-1705
Mailing address:
  • Phone: 919-967-2927
  • Fax: 919-967-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24124
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: