Provider Demographics
NPI:1235286733
Name:PANCALDO, ARIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIANA
Middle Name:
Last Name:PANCALDO
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 1:610 JONES FERRY RD
Mailing Address - Street 2:STE 102
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6113
Mailing Address - Country:US
Mailing Address - Phone:919-929-1747
Mailing Address - Fax:919-933-5168
Practice Address - Street 1:610 JONES FERRY RD
Practice Address - Street 2:STE 102
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6113
Practice Address - Country:US
Practice Address - Phone:919-929-1747
Practice Address - Fax:919-933-5168
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8965428Medicaid
NCE52627Medicare UPIN
NC8965428Medicaid