Organization
CAROLINA HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOSHIA IHENYEN (ADMINISTRATOR)
(919) 282-4829
Entity
Organization
Contact information
Practice address
2634 DURHAM CHAPEL HILL BLVD STE 216, DURHAM, NC 27707-2800
(984) 244-7513
Mailing address
2634 DURHAM CHAPEL HILL BLVD STE 216, DURHAM, NC 27707-2800
(984) 244-7513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8939668
—
NC
Enumeration date
10/16/2019
Last updated
10/19/2019
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