Provider Demographics
NPI:1689678047
Name:PROSE, CLAUDIA CHANLETT (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:CHANLETT
Last Name:PROSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 E WENDOVER AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-832-3150
Mailing Address - Fax:
Practice Address - Street 1:301 E WENDOVER AVE
Practice Address - Street 2:STE 400
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1230
Practice Address - Country:US
Practice Address - Phone:336-832-3150
Practice Address - Fax:336-832-3151
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9700370208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133W4Medicaid
NC9700370OtherNC LICENSE
NCBP5968702OtherDEA
NC9700370OtherNC LICENSE