Basic Information
Provider Information
NPI: 1598350365
EntityType: 2
ReplacementNPI:  
OrganizationName: UNC PHYSICIANS GROUP PRACTICES II, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 PERIMETER PARK DR STE 200
Address2:  
City: MORRISVILLE
State: NC
PostalCode: 275608442
CountryCode: US
TelephoneNumber: 9842154111
FaxNumber:  
Practice Location
Address1: 1110 SE CARY PKWY STE 103
Address2:  
City: CARY
State: NC
PostalCode: 275187420
CountryCode: US
TelephoneNumber: 9192970000
FaxNumber: 9192325328
Other Information
ProviderEnumerationDate: 03/04/2021
LastUpdateDate: 03/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FISCUS
AuthorizedOfficialFirstName: LYNNE
AuthorizedOfficialMiddleName: CHRISTINE
AuthorizedOfficialTitleorPosition: AUTHORIZED OFFICIAL
AuthorizedOfficialTelephone: 9842154111
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home