Provider Demographics
NPI:1649939448
Name:SILGUERO-CLAY, CHADARRYL LASHUN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CHADARRYL
Middle Name:LASHUN
Last Name:SILGUERO-CLAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FINSBURY ST APT 7416
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7648
Mailing Address - Country:US
Mailing Address - Phone:423-779-6102
Mailing Address - Fax:
Practice Address - Street 1:1817 MARTIN LUTHER KING PKWY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3585
Practice Address - Country:US
Practice Address - Phone:919-402-1917
Practice Address - Fax:919-402-1941
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN116231131OtherDRIVER LICENSE NUMBER