Healthcare Provider Details

I. General information

NPI: 1427102748
Provider Name (Legal Business Name): CHANHTHEVY CHAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EMERGENCY ROOM DR RM DRIVE
CHAPEL HILL NC
27599-5035
US

IV. Provider business mailing address

320 EMERGENCY ROOM DRIVE UNC CAMPUS HEALTH
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-2281
  • Fax: 919-966-0108
Mailing address:
  • Phone: 919-966-2281
  • Fax: 919-966-0108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200300013
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: