Provider Demographics
NPI:1013443324
Name:AYOUB, CHAKIB MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAKIB
Middle Name:MAURICE
Last Name:AYOUB
Suffix:
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 1:3611 UNIVERSITY DR
Mailing Address - Street 2:APT#06E
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6209
Mailing Address - Country:US
Mailing Address - Phone:323-924-2087
Mailing Address - Fax:
Practice Address - Street 1:3611 UNIVERSITY DR
Practice Address - Street 2:APT#06E
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6209
Practice Address - Country:US
Practice Address - Phone:323-924-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist