Provider Demographics
NPI:1326348160
Name:MACIAS, LOREN THOMAS-CHEW (PA-C)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:THOMAS-CHEW
Last Name:MACIAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11314 US 15 501 N
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-6374
Mailing Address - Country:US
Mailing Address - Phone:199-295-6649
Mailing Address - Fax:
Practice Address - Street 1:11314 US 15 501 N
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-6374
Practice Address - Country:US
Practice Address - Phone:919-929-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2697363A00000X
NC001002483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant