Basic Information
Provider Information
NPI: 1962575621
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIAZ-GONZALEZ FERRIS
FirstName: MARIA
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FERRIS
OtherFirstName: MARIA
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 2
Mailing Information
Address1: 143 W FRANKLIN ST
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275162539
CountryCode: US
TelephoneNumber: 9199664996
FaxNumber: 9198435515
Practice Location
Address1: 101 MANNING DR
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275990001
CountryCode: US
TelephoneNumber: 9199664996
FaxNumber: 9198435515
Other Information
ProviderEnumerationDate: 11/17/2006
LastUpdateDate: 08/12/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X2001130NYY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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