MEDICARE: CHARLES J VIVIANO MD

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	174400000X	Specialist	044379	CT
2	208800000X	Urology Physician	2011-00406	NC

General Provider Information

NPI Number	:	1740213867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES J VIVIANO MD

Provider Business Mailing Address
First Line	:	5213 S ALSTON AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-4430
Country	:	US
Telephone Number	:	919-684-8111
Fax Number	:

Provider Business Practice Location Address
First Line	:	3480 WAKE FOREST RD
Second Line	:	STE 506
City	:	RALEIGH
State	:	NC
Zip	:	27609-7376
Country	:	US
Telephone Number	:	919-862-5600
Fax Number	:

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

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	05/08/2012

Similar Medicare Providers

1386618379 — ANN E WHITAKER PA
Practice Location Address:

3480 WAKE FOREST RD , SUITE 500
RALEIGH, NC
27609-7376

Practice Phone: 919-862-5650
Practice Fax:

1720028558 — PIEDMONT SPINE SPECIALISTS, PA
Practice Location Address:

3480 WAKE FOREST RD , SUITE 208
RALEIGH, NC
27609-7376

Practice Phone: 919-781-4541
Practice Fax: 919-781-4812

1245267269 — JOSHUA SMITH MS, ATC, MHS, PA-C
Practice Location Address:

3480 WAKE FOREST RD STE 208
RALEIGH, NC
27609-7376

Practice Phone: 919-781-4541
Practice Fax:

1548298334 — JON JAY WILSON DO
Practice Location Address:

3480 WAKE FOREST RD , SUITE 208
RALEIGH, NC
27609-7376

Practice Phone: 919-781-4541
Practice Fax: 919-781-4812

1427081611 — PRIVATE DIAGNOSTIC CLINIC, PLLC
Practice Location Address:

3480 WAKE FOREST RD , SUITE 502
RALEIGH, NC
27609-7376

Practice Phone: 919-862-5620
Practice Fax:

1497771992 — PRIVATE DIAGNOSTIC CLINIC, PLLC
Practice Location Address:

3480 WAKE FOREST RD , SUITE 414
RALEIGH, NC
27609-7376

Practice Phone: 919-684-8111
Practice Fax:

Directions to “ CHARLES J VIVIANO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.