Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 0101241408 | VA |
Y | 2080P0201X | Pediatric Allergist | 2012-01332 | NC |
NPI | 1174726731 |
---|---|
Provider Name | Amy P Stallings |
First Address | Durham, NC 27713-4430 |
Second Address | Raleigh, NC 27609-7376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 19/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174726731 | (05) | VA |