Provider Demographics
NPI:1922204999
Name:WELBORN, DORIS (RD,LDN,CDE)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:WELBORN
Suffix:
Gender:F
Credentials:RD,LDN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 FRIDAY CENTER DR
Mailing Address - Street 2:SUITE 2091, ROOM 2101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9499
Mailing Address - Country:US
Mailing Address - Phone:919-966-0420
Mailing Address - Fax:
Practice Address - Street 1:163 MEDICAL PARK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-6790
Practice Address - Country:US
Practice Address - Phone:919-799-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000907133V00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2992275Medicare ID - Type UnspecifiedREGISTERED DIETICIAN