Provider Demographics
NPI:1265476568
Name:CHALFA, NICOLAI (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLAI
Middle Name:
Last Name:CHALFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 QUAKER LN
Mailing Address - Street 2:STE.207C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:336-883-9728
Practice Address - Street 1:1720 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7007
Practice Address - Country:US
Practice Address - Phone:336-883-9675
Practice Address - Fax:336-883-2615
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0022296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1851OtherCIGNA
5254261OtherAETNA
58678OtherMEDCOST
15469OtherPARTNERS
21870OtherBCBS
NC21870OtherBCBS
NC7921870Medicaid
80183242OtherMEDICARE RAILROAD
102235OtherUNITED HEALTHCARE
5254261OtherAETNA
NCF20477Medicare UPIN