Provider Demographics
NPI:1265452270
Name:CHANDLER, MARK C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
Last Name:CHANDLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3713 UNIVERSITY DR
Mailing Address - Street 2:STE B
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6202
Mailing Address - Country:US
Mailing Address - Phone:919-401-6212
Mailing Address - Fax:919-401-4170
Practice Address - Street 1:3713 UNIVERSITY DR
Practice Address - Street 2:STE B
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6202
Practice Address - Country:US
Practice Address - Phone:919-401-6212
Practice Address - Fax:919-401-4170
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2018-03-07
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Provider Licenses
StateLicense IDTaxonomies
NC310002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8921983Medicaid