Provider Demographics
NPI:1447577374
Name:CHAPEL HILL INTEGRATIVE MEDICINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:CHAPEL HILL INTEGRATIVE MEDICINE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COEYTAUX
Authorized Official - Suffix:X
Authorized Official - Credentials:MD
Authorized Official - Phone:919-929-7990
Mailing Address - Street 1:55 VILCOM CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1689
Mailing Address - Country:US
Mailing Address - Phone:919-929-7990
Mailing Address - Fax:919-929-7991
Practice Address - Street 1:55 VILCOM CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1689
Practice Address - Country:US
Practice Address - Phone:919-929-7990
Practice Address - Fax:919-929-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0061961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty