Provider Demographics
NPI:1083882419
Name:VERGUN, ANNA DIMITRIOVNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:DIMITRIOVNA
Last Name:VERGUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:V
Other - Last Name:CUOMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:130 MASON FARM RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7055
Mailing Address - Country:US
Mailing Address - Phone:919-843-3378
Mailing Address - Fax:919-966-6730
Practice Address - Street 1:130 MASON FARM RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599
Practice Address - Country:US
Practice Address - Phone:919-843-3378
Practice Address - Fax:919-966-6730
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91690207X00000X
NC2014-01226207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery