Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 20744 | NC |
Y | 111NI0900X | Internist | 20744 | NC |
N | 207RA0401X | Internist - Addiction Medicine | 20744 | NC |
NPI | 1053381863 |
---|---|
Provider Name | Dr. Allan Dale Nash |
First Address | Brevard, NC 28712 |
Second Address | Brevard, NC 28712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 10/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8961853 | (05) | NC |
E00441 | (02) | NC |