Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301086529 | MI |
Y | 2080P0205X | Pediatric Endocrinologist | 2008-01642 | NC |
NPI | 1447384797 |
---|---|
Provider Name | Dr. Kateryna V Kotlyarevska |
First Address | Wilmington, NC 28403-1743 |
Second Address | Wilmington, NC 28401-7407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 12/02/2009 |