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Individual

KERRY EILEEN CHANDLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3949 BROWNING PL, RALEIGH, NC 27609-6504
(919) 787-8221
(919) 789-4461
Mailing address
PO BOX 19368, RALEIGH, NC 27619-9368
(919) 787-8221
(919) 789-4461

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
96-01755
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1031J
BLUECROSS BLUESHIELD
NC
01
16-54688
UNITED HEALTHCARE
NC
01
16-54689
UNITED HEALTHCARE
NC
01
16-54690
UNITED HEALTHCARE
NC
01
300071496
RAILROAD MEDICARE
NC
01
300071497
RAILROAD MEDICARE
NC
01
300071498
RAILROAD MEDICARE
NC
01
78137
MEDCOST
NC
01
79461
MEDCOST
NC
01
79463
MEDCOST
NC
05
891031J
NC
Enumeration date
05/01/2006
Last updated
03/26/2019
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