Provider Demographics
NPI:1174985402
Name:BEBYN, CARLY JO (DO)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:JO
Last Name:BEBYN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 ARRINGDON PARK DR STE 150
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5643
Mailing Address - Country:US
Mailing Address - Phone:919-385-6510
Mailing Address - Fax:
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5643
Practice Address - Country:US
Practice Address - Phone:919-385-6510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-02275208000000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program