Provider Demographics
NPI:1679996292
Name:UNC PHYSICIANS NETWORK LLC
Entity type:Organization
Organization Name:UNC PHYSICIANS NETWORK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:FISCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:984-215-4111
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1181 WEAVER DAIRY RD STE 250
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1870
Practice Address - Country:US
Practice Address - Phone:984-215-4340
Practice Address - Fax:984-215-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1679996292Medicaid
NC1679996292Medicaid