Provider Demographics
NPI:1932242120
Name:ARTIS, AVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:AVIS
Middle Name:
Last Name:ARTIS
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 1:4116 CAPITOL ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2152
Mailing Address - Country:US
Mailing Address - Phone:919-471-1573
Mailing Address - Fax:
Practice Address - Street 1:4116 CAPITOL ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2152
Practice Address - Country:US
Practice Address - Phone:919-471-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38292207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911992Medicaid
NC2144469AMedicare PIN
E29368Medicare UPIN
NC2144469DMedicare PIN