Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 34602 | NC |
NPI | 1275534844 |
---|---|
Provider Name | Dr. Irma Fiordalisi |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 02/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32079 | BCBS NC (01) | NC |
370015144 | RAILROAD MEDICARE (01) | NC |
8932079 | (05) | NC |
F15031 | (02) | NC |