Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 173151 | NC |
N | 207NS0135X | Procedural Dermatology | 173151 | NC |
NPI | 1174813851 |
---|---|
Provider Name | Dr. Leah Scanlin Ronald |
First Address | Durham, NC 27707-6038 |
Second Address | Chicago, IL 60657-5640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2011 |
Last Update Date | 14/03/2014 |