Provider Demographics
NPI:1689881294
Name:COMPREHENSIVE FAMILY MEDICINE PA
Entity Type:Organization
Organization Name:COMPREHENSIVE FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-932-1171
Mailing Address - Street 1:1717 LEGION RD
Mailing Address - Street 2:STE 103
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517
Mailing Address - Country:US
Mailing Address - Phone:919-932-1171
Mailing Address - Fax:919-933-1377
Practice Address - Street 1:1717 LEGION RD
Practice Address - Street 2:STE 103
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517
Practice Address - Country:US
Practice Address - Phone:919-932-1171
Practice Address - Fax:919-933-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
017JUOtherBC
NC5902773Medicaid
NC5902773Medicaid
017JUOtherBC