Provider Demographics
NPI:1831183292
Name:CHIODO, MARY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:CHIODO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TILGHMAN DR
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-5510
Mailing Address - Country:US
Mailing Address - Phone:910-892-1333
Mailing Address - Fax:910-892-2757
Practice Address - Street 1:104 TILGHMAN DR
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-5510
Practice Address - Country:US
Practice Address - Phone:910-892-1333
Practice Address - Fax:910-892-2929
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400444208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC22380OtherBLUE CROSS
NC8922380Medicaid
F43719Medicare UPIN