Provider Demographics
NPI:1982605895
Name:CHIN, TANYA ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:ELIZABETH
Last Name:CHIN
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 1:400 EASTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2313
Mailing Address - Country:US
Mailing Address - Phone:919-966-8279
Mailing Address - Fax:
Practice Address - Street 1:1824 PISGAH DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791
Practice Address - Country:US
Practice Address - Phone:828-694-8427
Practice Address - Fax:828-694-8428
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401622207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902136Medicaid
NCNCT970BOtherMEDICARE PIN
NCI45394Medicare UPIN
NCNCT970AMedicare PIN