Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35073432R | OH |
NPI | 1245294206 |
---|---|
Provider Name | Cristine Radojicic |
First Address | Durham, NC 27713-8507 |
Second Address | Durham, NC 27713-8507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 04/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2140696 | (05) | OH |
G81665 | (02) | OH |