MEDICARE: NATHANIEL AVERY KIDDER ERSKINE

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
1	2083P0901X	Public Health & General Preventive Medicine Physician	202200216	NC

General Provider Information

NPI Number	:	1730640723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL AVERY KIDDER ERSKINE

Provider Business Mailing Address
First Line	:	590 MANNING DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-6119
Country	:	US
Telephone Number	:	984-974-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 MANNING DRIVE UNC PREVENTIVE MEDICINE PROGRAM
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-4220
Country	:	US
Telephone Number	:	984-974-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2019
Last Update Date	:	05/11/2023

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