Provider Demographics
NPI:1760409320
Name:KARRENBAUER, CAMTU NGUYEN
Entity Type:Individual
Prefix:DR
First Name:CAMTU
Middle Name:NGUYEN
Last Name:KARRENBAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:CAMTU
Other - Middle Name:NGUYEN
Other - Last Name:KARRENBAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:55 VILCOM CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1689
Mailing Address - Country:US
Mailing Address - Phone:919-929-7990
Mailing Address - Fax:919-929-7991
Practice Address - Street 1:55 VILCOM CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1689
Practice Address - Country:US
Practice Address - Phone:919-929-7990
Practice Address - Fax:919-929-7991
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039974207Q00000X
NC2013-01367207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT039974OtherSTATE LICENSE
NC2013-01367OtherNC LICENSE
CT001399741Medicaid
CT001399741Medicaid
CT039974OtherSTATE LICENSE
G66529Medicare UPIN