Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35090285 | OH |
Y | 208000000X | Pediatrician | 35506 | SC |
NPI | 1003007857 |
---|---|
Provider Name | Angela Murray Young |
First Address | Greenville, SC 29615-4545 |
Second Address | Greenville, SC 29605-4267 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 16/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
355065 | (05) | SC |