Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 51600 | SC |
N | 207RC0000X | Internist - Cardiovascular Disease | D50595 | MD |
NPI | 1790726917 |
---|---|
Provider Name | Daniel P Judge |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 27/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138600000 | (05) | MD |
G29369 | (02) | MD |