Provider Demographics
NPI:1497743447
Name:CHEEK, NATHAN M JR (OD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:M
Last Name:CHEEK
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S FIFTH ST
Mailing Address - Street 2:PO BOX 236
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-0236
Mailing Address - Country:US
Mailing Address - Phone:919-563-3226
Mailing Address - Fax:919-563-5226
Practice Address - Street 1:206 S FIFTH ST
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-2704
Practice Address - Country:US
Practice Address - Phone:919-563-3226
Practice Address - Fax:919-563-5226
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1542152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U54002Medicare UPIN
NC1291850001Medicare NSC
NC2469472CMedicare PIN