Provider Demographics
NPI:1013945732
Name:SEBASTIAN, SIBY (PHD)
Entity type:Individual
Prefix:DR
First Name:SIBY
Middle Name:
Last Name:SEBASTIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HEWITT CT
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7716
Mailing Address - Country:US
Mailing Address - Phone:919-613-8432
Mailing Address - Fax:919-668-5424
Practice Address - Street 1:4425 BEN FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2147
Practice Address - Country:US
Practice Address - Phone:919-613-8432
Practice Address - Fax:919-668-5424
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics