Healthcare Provider Details

I. General information

NPI: 1013945732
Provider Name (Legal Business Name): SIBY SEBASTIAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 BEN FRANKLIN BLVD
DURHAM NC
27704-2147
US

IV. Provider business mailing address

107 HEWITT CT
MORRISVILLE NC
27560-7716
US

V. Phone/Fax

Practice location:
  • Phone: 919-613-8432
  • Fax: 919-668-5424
Mailing address:
  • Phone: 919-613-8432
  • Fax: 919-668-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: