Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME91993 | FL |
Y | 208600000X | Surgeon | ME91993 | FL |
N | 2086S0120X | Pediatric Surgery | C100 | DE |
NPI | 1225040561 |
---|---|
Provider Name | Charles Paidas |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
271349700 | (05) | FL |
50994 | BLUE CROSS BLUE SHIELD (01) | FL |
E45600 | (02) | FL |