Provider Demographics
NPI:1770664880
Name:COLEY, SILAS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:SILAS
Middle Name:
Last Name:COLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 KENMORE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1445
Mailing Address - Country:US
Mailing Address - Phone:919-929-0326
Mailing Address - Fax:919-929-8033
Practice Address - Street 1:101 CONNER DR
Practice Address - Street 2:SUITE 404, WILLOWCREST BUILDING
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7038
Practice Address - Country:US
Practice Address - Phone:919-929-0326
Practice Address - Fax:919-929-8033
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC146282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8923763Medicaid
NC23763OtherBLUE CROSS-BLUE SHIELD
NC201540Medicare ID - Type Unspecified
NC8923763Medicaid