Provider Demographics
NPI:1043947104
Name:NORTH CAROLINA VASCULAR CENTER PLLC
Entity Type:Organization
Organization Name:NORTH CAROLINA VASCULAR CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CHALIFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-971-4580
Mailing Address - Street 1:920 S. LOMBARD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLAYTON, NC
Mailing Address - State:NC
Mailing Address - Zip Code:27520
Mailing Address - Country:US
Mailing Address - Phone:919-971-4580
Mailing Address - Fax:
Practice Address - Street 1:920 S. LOMBARD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CLAYTON, NC
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-971-4580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty