Provider Demographics
NPI:1013241892
Name:THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
Entity type:Organization
Organization Name:THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUGIRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-843-7449
Mailing Address - Street 1:110 CONNER DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7044
Mailing Address - Country:US
Mailing Address - Phone:919-843-7449
Mailing Address - Fax:
Practice Address - Street 1:110 CONNER DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7044
Practice Address - Country:US
Practice Address - Phone:919-843-7449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103T00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty