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General NPI Number Information
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NPI Number | 1275872905
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Entity Type | Organization
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Legal Business Name | UNC PHYSICIANS NETWORK GROUP PRACTICES, LLC
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 8300 HEALTH PARK DR. SUITE #320
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City | RALEIGH
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State | NC
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Zip | 27615-4731
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Country | US
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Telephone | 919-781-9650
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Fax |
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | LYNNE CHRISTINE FISCUS
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Credential | MD
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Telephone | 984-215-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NC
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