Healthcare Provider Details

I. General information

NPI: 1013109594
Provider Name (Legal Business Name): CHAD ROBERT HALDEMAN-ENGLERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 N ELM ST STE 1A
GREENSBORO NC
27401-1023
US

IV. Provider business mailing address

300 E WENDOVER AVE
GREENSBORO NC
27401-1229
US

V. Phone/Fax

Practice location:
  • Phone: 336-890-2439
  • Fax:
Mailing address:
  • Phone: 336-663-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2009-00193
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberMD428622
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number2009-00193
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: