Provider Demographics
NPI:1134575913
Name:UNC SCHOOL OF MEDICINE AND HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:UNC SCHOOL OF MEDICINE AND HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGERY RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKKIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-840-3769
Mailing Address - Street 1:160 DENTAL CIR
Mailing Address - Street 2:ROOM 4032 BURNETT-WOMACK BLDG., CB#7050
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-5021
Mailing Address - Country:US
Mailing Address - Phone:919-966-4653
Mailing Address - Fax:
Practice Address - Street 1:160 DENTAL CIR
Practice Address - Street 2:ROOM 4032 BURNETT-WOMACK BLDG., CB#7050
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-5021
Practice Address - Country:US
Practice Address - Phone:919-966-4653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC218624282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital