Healthcare Provider Details

I. General information

NPI: 1922204999
Provider Name (Legal Business Name): DORIS WELBORN RD,LDN,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 MEDICAL PARK DR SUITE 120
SILER CITY NC
27344-6790
US

IV. Provider business mailing address

211 FRIDAY CENTER DR SUITE 2091, ROOM 2101
CHAPEL HILL NC
27517-9499
US

V. Phone/Fax

Practice location:
  • Phone: 919-799-4722
  • Fax:
Mailing address:
  • Phone: 919-966-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL000907
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberL000907
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: