Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | MD.203711 | LA |
Y | 207NS0135X | Procedural Dermatology | 0101267201 | VA |
N | 207NS0135X | Procedural Dermatology | MD.203711 | LA |
NPI | 1548475189 |
---|---|
Provider Name | Connor A Patterson |
First Address | Fredericksburg, VA 22401-6233 |
Second Address | Fredericksburg, VA 22401-6233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 07/09/2019 |