Provider Demographics
NPI:1578839395
Name:SOOD, CHANCHALDEEP KAUR (MD)
Entity Type:Individual
Prefix:
First Name:CHANCHALDEEP
Middle Name:KAUR
Last Name:SOOD
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 1:3300 THURSTON BLDG
Mailing Address - Street 2:CB# 7280
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7280
Mailing Address - Country:US
Mailing Address - Phone:919-962-5136
Mailing Address - Fax:
Practice Address - Street 1:3300 THURSTON BLDG
Practice Address - Street 2:CB# 7280
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599
Practice Address - Country:US
Practice Address - Phone:919-962-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-00092208000000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208000000XAllopathic & Osteopathic PhysiciansPediatrics