Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101054279 | VA |
N | 2080A0000X | Adolescent Medicine | 0101054279 | VA |
NPI | 1245223601 |
---|---|
Provider Name | Dr. Candace Rowland Pate |
First Address | Richmond, VA 23225 |
Second Address | Richmond, VA 23225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 03/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200257 | SOUTHERN HEALTH (01) | VA |
3119833 | MAMSI (01) | VA |
437065 | ANTHEM (01) | VA |
6736726 | (05) | VA |
6736726 | SENTARA (01) | VA |
6736726 | VIRGINIA PREMIER (01) | VA |
G28328 | (02) | VA |