Provider Demographics
NPI:1295715613
Name:GILDEN-CHIANG, SUZANNE JEAN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:JEAN
Last Name:GILDEN-CHIANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 FALLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7132
Mailing Address - Country:US
Mailing Address - Phone:919-484-9816
Mailing Address - Fax:
Practice Address - Street 1:6911 GARRETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5635
Practice Address - Country:US
Practice Address - Phone:919-451-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102581363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC102581OtherNC MEDICAL LICENSE