Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 2014-00838 | NC |
N | 207R00000X | Internist | 165244 | NC |
N | 111NI0900X | Internist | 165244 | NC |
NPI | 1013233352 |
---|---|
Provider Name | Alyssa Searles Daniel |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28210-3361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2010 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013233352 | (05) | NC |
NC2200 | (05) | SC |