Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 980095 | NC |
N | 2080P0201X | Pediatric Allergist | 980095 | NC |
NPI | 1114092962 |
---|---|
Provider Name | Dr. Paul David Mehlhop |
First Address | Greenville, NC 27834 |
Second Address | Greenville, NC 27834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 28/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891116T | (05) | NC |
G67816 | (02) | NC |