Healthcare Provider Details

I. General information

NPI: 1477193589
Provider Name (Legal Business Name): UWH OF THE CAROLINAS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PERIMETER PARK DR STE C
MORRISVILLE NC
27560-9714
US

IV. Provider business mailing address

200 PERIMETER PARK DR STE C
MORRISVILLE NC
27560-9714
US

V. Phone/Fax

Practice location:
  • Phone: 919-334-0123
  • Fax: 919-334-0152
Mailing address:
  • Phone: 919-334-0123
  • Fax: 919-334-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMY WALKER
Title or Position: PROVIDER ENROLLMENT COORDINATOR
Credential:
Phone: 561-300-2410