Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | NC |
NPI | 1013945732 |
---|---|
Provider Name | Dr. Siby Sebastian |
First Address | Morrisville, NC 27560-7716 |
Second Address | Durham, NC 27704-2147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |