Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 2017-02209 | NC |
N | 207N00000X | Dermatologist | 35 095191 | OH |
N | 207N00000X | Dermatologist | ME126309 | FL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 201702209 | NC |
N | 207ND0101X | MOHS-Micrographic Surgeon | 35.095191 | OH |
N | 207ND0101X | MOHS-Micrographic Surgeon | ME126309 | FL |
NPI | 1427370352 |
---|---|
Provider Name | Adam Ingraffea |
First Address | Cary, NC 27519-5576 |
Second Address | Cary, NC 27519-5576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2010 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
KFPP7 | BLUE CROSS BLUE SHIELD (01) | FL |