Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 036152719 | IL |
Y | 207RP1001X | Pulmonary Disease | 036152719 | IL |
NPI | 1053678755 |
---|---|
Provider Name | Dr. Nida Junaid |
First Address | Carbondale, IL 62902-3988 |
Second Address | Carbondale, IL 62901-1474 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2012 |
Last Update Date | 20/10/2021 |