Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2020-03210 | NC |
Y | 207RP1001X | Pulmonary Disease | 2020-03210 | NC |
NPI | 1073920286 |
---|---|
Provider Name | Dr. Ritu Modi |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-2849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2014 |
Last Update Date | 04/12/2020 |