Provider Demographics
NPI:1952376659
Name:EILY, KIARA SIMONE (MD)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:SIMONE
Last Name:EILY
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 1:809 SPRING FOREST RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-9700
Mailing Address - Country:US
Mailing Address - Phone:919-803-4268
Mailing Address - Fax:919-977-1381
Practice Address - Street 1:809 SPRING FOREST RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-9700
Practice Address - Country:US
Practice Address - Phone:919-803-4268
Practice Address - Fax:919-977-1381
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36330207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8923469Medicaid
NC23469OtherBLUE CROSS
NCF69323Medicare UPIN
NC2192824AMedicare PIN