Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2013-01493 | NC |
NPI | 1003127507 |
---|---|
Provider Name | Dr. Perry Scott Agbuya JR. |
First Address | Charlotte, NC 28260-0447 |
Second Address | Greensboro, NC 27408-7025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2010 |
Last Update Date | 10/08/2021 |