Provider Demographics
NPI:1144253212
Name:CHELLI, HEPHZIBAH ESTHER (MD)
Entity type:Individual
Prefix:
First Name:HEPHZIBAH
Middle Name:ESTHER
Last Name:CHELLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 UNIVERSITY DR BLDG 700
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3489
Mailing Address - Country:US
Mailing Address - Phone:919-237-1337
Mailing Address - Fax:
Practice Address - Street 1:115 CRESCENTCOMMONS DR STE 100
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8102
Practice Address - Country:US
Practice Address - Phone:919-803-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-02236207Q00000X, 207Q00000X
IA37950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1155253212Medicaid
IAR7957OtherLICENSE NUMBER
IA1144253212Medicaid
IA719260112Medicare PIN