Healthcare Provider Details

I. General information

NPI: 1336169937
Provider Name (Legal Business Name): UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 EAST ST
PITTSBORO NC
27312-8816
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 919-545-0911
  • Fax:
Mailing address:
  • Phone: 919-804-5064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

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