Provider Demographics
NPI:1508835844
Name:CHAO, IRENE ST (MD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:ST
Last Name:CHAO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:101 SW CARY PKWY
Mailing Address - Street 2:SUITE 270
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5562
Mailing Address - Country:US
Mailing Address - Phone:919-467-5543
Mailing Address - Fax:919-469-2391
Practice Address - Street 1:101 SW CARY PKWY
Practice Address - Street 2:SUITE 270
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5562
Practice Address - Country:US
Practice Address - Phone:919-467-5543
Practice Address - Fax:919-469-2391
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC9800494208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912281Medicaid
NC8912281Medicaid