=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518235597
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNC PHYSICIANS NETWORK, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2011
-----------------------------------------------------
Last Update Date | 06/26/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6216 FAYETTEVILLE RD SUITE #105
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27713-6287
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-405-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1600 PERIMETER PARK DR SUITE #225
-----------------------------------------------------
City | MORRISVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27560-8421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | ROBERT L GIANFORCARO
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 919-923-0660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------