Provider Demographics
NPI:1902803109
Name:DAY, CAROLYN SHANLEY (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:SHANLEY
Last Name:DAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:SHANLEY
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2800 BLUE RIDGE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-4988
Mailing Address - Country:US
Mailing Address - Phone:919-784-7874
Mailing Address - Fax:919-784-2708
Practice Address - Street 1:2800 BLUE RIDGE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-4988
Practice Address - Country:US
Practice Address - Phone:919-784-7874
Practice Address - Fax:919-784-2708
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201301684208600000X
KY35799174400000X
IN01066148A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200929560Medicaid
KY0918302OtherMEDICARE
KY64072952Medicaid
KY000000330047OtherANTHEM FACET NUMBER
KY50004060Medicaid
KYP00136405OtherMEDICARE RAILROAD
KY64072952Medicaid
KYH89193Medicare UPIN