Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M2289 | TX |
Y | 2080P0210X | Pediatric Nephrologist | 200001356 | NC |
N | 2080P0210X | Pediatric Nephrologist | 85276 | NC |
NPI | 1982626370 |
---|---|
Provider Name | Annabelle Nancy Chua |
First Address | Charlotte, NC 28260-1372 |
Second Address | Charlotte, NC 28203-5866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 16/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1982626370 | (05) | NC |
I45911 | (02) | TX |
NC1928 | (05) | SC |