Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 2021-02710 | NC |
N | 2080P0207X | Pediatric Hematology-Oncologist | 305400 | LA |
NPI | 1184043176 |
---|---|
Provider Name | Andrea Bauchat |
First Address | Durham, NC 27703-9449 |
Second Address | Durham, NC 27705-3976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 15/09/2021 |