Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 200800822 | NC |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 200800822 | NC |
NPI | 1831168202 |
---|---|
Provider Name | Dr. Jamie Rebecca Scaglione |
First Address | Concord, NC 28025-2434 |
Second Address | Concord, NC 28025-2434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 16/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2008-00822 | NC MEDICAL BOARD (01) | NC |