Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 97-00702 | NC |
N | 2081P2900X | Pain Medicine | 9700702 | NC |
NPI | 1255334934 |
---|---|
Provider Name | Dwayne E Patterson |
First Address | Raleigh, NC 27613-1682 |
Second Address | Raleigh, NC 27613-1682 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 05/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G60126 | (02) |