Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 34615 | NC |
Y | 207Q00000X | Family Doctor | 34615 | NC |
NPI | 1003838251 |
---|---|
Provider Name | Dino A Graziano |
First Address | Gastonia, NC 28056-8869 |
Second Address | Gastonia, NC 28056-8869 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8936843 | (05) | NC |
E61851 | (02) | NC |