Provider Demographics
NPI:1790709269
Name:REGUYAL, CHONA S (MD)
Entity Type:Individual
Prefix:
First Name:CHONA
Middle Name:S
Last Name:REGUYAL
Suffix:
Gender:F
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:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:828-694-8350
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:2695 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8576
Practice Address - Country:US
Practice Address - Phone:828-694-8420
Practice Address - Fax:828-694-8421
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCJ738BOtherMEDICARE PTAN
NCP01447323OtherRR MEDICARE
NC891348HMedicaid
NC2022314BOtherMEDICARE PTAN
NC891348HMedicaid