Provider Demographics
NPI:1114907656
Name:IGLESIAS, DANA MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE
Last Name:IGLESIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNC FAMILY PRACTICE CTR
Mailing Address - Street 2:CB #7595
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-966-3711
Mailing Address - Fax:919-966-6125
Practice Address - Street 1:590 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6119
Practice Address - Country:US
Practice Address - Phone:919-966-3711
Practice Address - Fax:919-966-6125
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92672207Q00000X
NC200900657207Q00000X
NC2009-00657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A926720Medicaid
CAI49087Medicare UPIN