Provider Demographics
NPI:1962191445
Name:AVENDANO, ANNIKA MARIE (MD)
Entity type:Individual
Prefix:
First Name:ANNIKA
Middle Name:MARIE
Last Name:AVENDANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNIKA
Other - Middle Name:MARIE
Other - Last Name:DIRKSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:CAMPUS BOX 7593
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7593
Mailing Address - Country:US
Mailing Address - Phone:919-966-3172
Mailing Address - Fax:984-974-9609
Practice Address - Street 1:6013 FARRINGTON RD STE 301
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8173
Practice Address - Country:US
Practice Address - Phone:984-974-6669
Practice Address - Fax:984-974-9609
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCDIRK-7Z1LKC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program