Provider Demographics
NPI:1417074204
Name:GRILLEY-OLSON, JUNEKO ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:JUNEKO
Middle Name:ELAINE
Last Name:GRILLEY-OLSON
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:UNC CHAPEL HILL DIVISION OF HEMATOLOGY ONCOLOGY
Mailing Address - Street 2:CB 7305, 3009 OLD CLINIC BLDG
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7305
Mailing Address - Country:US
Mailing Address - Phone:919-966-4970
Mailing Address - Fax:
Practice Address - Street 1:UNC CHAPEL HILL DIVISION OF HEMATOLOGY ONCOLOGY
Practice Address - Street 2:CB 7305, 3009 OLD CLINIC BLDG
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7305
Practice Address - Country:US
Practice Address - Phone:919-966-4970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAN3208065960146207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP960146Medicare UPIN