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NPI Code Detail

MEDICARE: KERRY EILEEN CHANDLER M.D.

MEDICARE: KERRY EILEEN CHANDLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician96-01755NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1300071498OTHERNCRAILROAD MEDICARE
6300071496OTHERNCRAILROAD MEDICARE
8300071497OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
279463OTHERNCMEDCOST
31031JOTHERNCBLUECROSS BLUESHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
516-54688OTHERNCUNITED HEALTHCARE
716-54690OTHERNCUNITED HEALTHCARE
978137OTHERNCMEDCOST
1079461OTHERNCMEDCOST
1116-54689OTHERNCUNITED HEALTHCARE

General Provider Information

NPI Number : 1285692244
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY EILEEN CHANDLER M.D.
Provider Business Mailing Address
First Line : PO BOX 19368
Second Line :
City : RALEIGH
State : NC
Zip : 27619-9368
Country : US
Telephone Number : 919-787-8221
Fax Number : 919-789-4461
Provider Business Practice Location Address
First Line : 3949 BROWNING PL
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6504
Country : US
Telephone Number : 919-787-8221
Fax Number : 919-789-4461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 03/26/2019

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Directions to “ KERRY EILEEN CHANDLER M.D.” Practice Location

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