Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 201501886 | NC |
N | 2080P0203X | Pediatric Critical Care Doctor | 2015-01886 | NC |
N | 2080P0203X | Pediatric Critical Care Doctor | 70934 | FL |
N | 2080P0203X | Pediatric Critical Care Doctor | ME91053 | FL |
NPI | 1124037692 |
---|---|
Provider Name | David Charles Pettigrew |
First Address | Asheville, NC 28803-3499 |
Second Address | Asheville, NC 28801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 07/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270801900 | (05) | FL |