Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2018-000084 | NC |
N | 111NI0900X | Internist | 2018-000084 | NC |
N | 207R00000X | Internist | 34.010455 | OH |
N | 111NI0900X | Internist | 34.010455 | OH |
N | 207R00000X | Internist | 5101020143 | MI |
N | 111NI0900X | Internist | 5101020143 | MI |
Y | 207RC0000X | Internist - Cardiovascular Disease | 2018-00084 | NC |
N | 207RC0000X | Internist - Cardiovascular Disease | 34.010455 | OH |
NPI | 1023250396 |
---|---|
Provider Name | Dr. Bryan J Pace |
First Address | Charlotte, NC 28275-1177 |
Second Address | Asheville, NC 28803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 21/05/2018 |