Healthcare Provider Details

I. General information

NPI: 1588606982
Provider Name (Legal Business Name): ANDREA CATHRYN BOZOKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/09/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 FINLEY GOLF COURSE RD STE 200
CHAPEL HILL NC
27517-4403
US

IV. Provider business mailing address

170 MANNING DRIVE CB 7025
CHAPEL HILL NC
27599-7025
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-4401
  • Fax:
Mailing address:
  • Phone: 919-843-1220
  • Fax: 517-432-3928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number4301063651
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01083537A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number2020-03840
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: