Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 9701855 | NC |
N | 2080P0208X | Pediatric Infectious Diseases | 222555 | MA |
NPI | 1073614897 |
---|---|
Provider Name | Dr. Megan E Reller |
First Address | Durham, NC 27710-4000 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 23/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2074877 | (05) | MA |
I14541 | (02) |