Provider Demographics
NPI:1659534089
Name:GIDDINGS, OLIVIA KATHRYN (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:KATHRYN
Last Name:GIDDINGS
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:801 E WOODCROFT PKWY
Mailing Address - Street 2:APT 901
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8266
Mailing Address - Country:US
Mailing Address - Phone:615-495-7809
Mailing Address - Fax:
Practice Address - Street 1:130 MASON FARM RD
Practice Address - Street 2:CB 7020
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27759
Practice Address - Country:US
Practice Address - Phone:919-966-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01053207R00000X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics