Provider Demographics
NPI:1174733943
Name:VAN EENWYK, CLAIRE (MD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:VAN EENWYK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:VAN EENWYK
Other - Last Name:CHEHRAZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2520 MERIDIAN PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4202
Mailing Address - Country:US
Mailing Address - Phone:919-666-4743
Mailing Address - Fax:
Practice Address - Street 1:6013 FARRINGTON RD
Practice Address - Street 2:SUITE 301
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8172
Practice Address - Country:US
Practice Address - Phone:919-962-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-00392207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology