Basic Information
| Provider Information | |||||||||
| NPI: | 1609134386 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LICHTMAN | ||||||||
| FirstName: | EBEN | ||||||||
| MiddleName: | ISAAC | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 MANNING DRIVE | ||||||||
| Address2: | 3RD FLOOR, CB# 7305 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27516 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 MANNING DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199664431 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2012 | ||||||||
| LastUpdateDate: | 06/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2015-00497 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 2015-00497 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.