Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2008-01449 | NC |
Y | 207RP1001X | Pulmonary Disease | 2008-01449 | NC |
N | 207RS0012X | Sleep Medicine | 2008-01449 | NC |
NPI | 1013964303 |
---|---|
Provider Name | Dr. Sajeev P Vettichira |
First Address | Morehead City, NC 28557-8998 |
Second Address | Morehead City, NC 28557-8998 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 02/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5910121 | (05) | NC |
5910121 | PTAN# 6472290001 (01) | NC |
F56001 | (02) |