Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2008-00653 | NC |
N | 208000000X | Pediatrician | L7214 | TX |
N | 208000000X | Pediatrician | ME0089059 | FL |
NPI | 1003996349 |
---|---|
Provider Name | Dr. Delouis Terlonge JR. |
First Address | Raleigh, NC 27609-6506 |
Second Address | Raleigh, NC 27609-6506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 06/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163939501 | (05) | TX |
I02601 | (02) |