Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 2016-00721 | NC |
NPI | 1003159179 |
---|---|
Provider Name | Candice Marlow Ray |
First Address | Durham, NC 27710 |
Second Address | Durham, NC 27710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 10/04/2019 |