Individual
LYNN A FORDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27599-0001
(919) 966-4131
Mailing address
143 W FRANKLIN ST, CHAPEL HILL, NC 27516-2539
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
36704
NC
2085P0229X
Pediatric Radiology Physician
Primary
36704
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300092926
RAIL ROAD MEDICARE
NC
05
—
8933068
—
NC
Enumeration date
09/26/2006
Last updated
02/09/2021
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