Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 055477 | GA |
N | 2080P0205X | Pediatric Endocrinologist | 2016-00107 | NC |
Y | 2080P0205X | Pediatric Endocrinologist | 46856 | TN |
NPI | 1386608404 |
---|---|
Provider Name | Dr. Melissa A. Carlucci |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 16/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
943231345A | (05) | GA |