Provider Demographics
NPI:1619940913
Name:COX, SUE ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUE ELLEN
Middle Name:
Last Name:COX
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 1:5821 FARRINGTON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9901
Mailing Address - Country:US
Mailing Address - Phone:919-403-6200
Mailing Address - Fax:919-403-6242
Practice Address - Street 1:5821 FARRINGTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9901
Practice Address - Country:US
Practice Address - Phone:919-403-6200
Practice Address - Fax:919-403-6242
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95-00542207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0235HOtherBLUE CROSS BLUE SHIELD
NC8924980Medicaid
NC0235HOtherBLUE CROSS BLUE SHIELD
NC8924980Medicaid