Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 0039 | NC |
NPI | 1073540357 |
---|---|
Provider Name | Dr. Ricardo Jose Padilla |
First Address | Chapel Hill, NC 27599-7450 |
Second Address | Chapel Hill, NC 27599-7450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5901529 | (05) | NC |
89902EG | (05) | NC |
902EG | BLUE CROSS BLUE SHIELD NC (01) | NC |