Healthcare Provider Details

I. General information

NPI: 1417074204
Provider Name (Legal Business Name): JUNEKO ELAINE GRILLEY-OLSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2007
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNC CHAPEL HILL DIVISION OF HEMATOLOGY ONCOLOGY CB 7305, 3009 OLD CLINIC BLDG
CHAPEL HILL NC
27599-7305
US

IV. Provider business mailing address

UNC CHAPEL HILL DIVISION OF HEMATOLOGY ONCOLOGY CB 7305, 3009 OLD CLINIC BLDG
CHAPEL HILL NC
27599-7305
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-4970
  • Fax:
Mailing address:
  • Phone: 919-966-4970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberAN3208065960146
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: