Provider Demographics
NPI:1659431849
Name:CHAMPION, MARGARET KERN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:KERN
Last Name:CHAMPION
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 1:1819 N LAKESHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6734
Mailing Address - Country:US
Mailing Address - Phone:919-967-5820
Mailing Address - Fax:919-928-0668
Practice Address - Street 1:820 S BOYLAN AVENUE
Practice Address - Street 2:DOROTHEA DIX HOSPITAL 3601 MAIL SERVICE CENTER
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-3601
Practice Address - Country:US
Practice Address - Phone:919-733-5540
Practice Address - Fax:919-733-0902
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC199132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
21982OtherBCBS PROVIDER NO
21982OtherBCBS PROVIDER NO
C85420Medicare UPIN