Provider Demographics
NPI:1033111976
Name:CHIN, DORIS (OD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:
Last Name:CHIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7016 HARPS MILL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3243
Mailing Address - Country:US
Mailing Address - Phone:919-847-6889
Mailing Address - Fax:919-847-2441
Practice Address - Street 1:7016 HARPS MILL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3243
Practice Address - Country:US
Practice Address - Phone:919-847-6889
Practice Address - Fax:919-847-2441
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1148152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0798070001OtherPALMETTO DMERC REGION C
NC8909149Medicaid
NC0798070001OtherPALMETTO DMERC REGION C
NCT64978Medicare UPIN