Healthcare Provider Details

I. General information

NPI: 1881689651
Provider Name (Legal Business Name): JANIE YUN CHAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 10/25/2020
Certification Date: 09/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6324 FAIRVIEW RD SUITE 350
CHARLOTTE NC
28210-3271
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-8600
  • Fax: 704-384-8610
Mailing address:
  • Phone: 704-384-8600
  • Fax: 704-384-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200400466
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: