Healthcare Provider Details

I. General information

NPI: 1700804622
Provider Name (Legal Business Name): UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5322 HIGHGATE DR SUITE 144
DURHAM NC
27713-6633
US

IV. Provider business mailing address

1600 PERIMETER PARK DR SUITE 225
MORRISVILLE NC
27560-8421
US

V. Phone/Fax

Practice location:
  • Phone: 919-806-3335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT LOUIS GIANFORCARO
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 919-804-5064