Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2016-02385 | NC |
N | 111NI0900X | Internist | 2016-02385 | NC |
N | 207RG0300X | Geriatric Medicine | 056681 | GA |
Y | 207RG0300X | Geriatric Medicine | 2016-02385 | NC |
NPI | 1073560702 |
---|---|
Provider Name | Dr. Pawan A Dhawan |
First Address | Pinehurst, NC 28374-8710 |
Second Address | Pinehurst, NC 28374-8710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 01/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I14131 | (02) |