Provider Demographics
NPI:1659343747
Name:CHAPEL HILL URGENT CARE PLLC
Entity Type:Organization
Organization Name:CHAPEL HILL URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MED. DIR.
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-403-8100
Mailing Address - Street 1:2238 NELSON HWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8914
Mailing Address - Country:US
Mailing Address - Phone:919-403-8100
Mailing Address - Fax:919-403-8005
Practice Address - Street 1:2238 NELSON HIGHWAY
Practice Address - Street 2:SUITE 500
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8914
Practice Address - Country:US
Practice Address - Phone:919-403-8100
Practice Address - Fax:919-403-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-03
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X
NC9701826207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H32577Medicare UPIN
NC2346887Medicare PIN