Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | NC |
NPI | 1639259104 |
---|---|
Provider Name | Edward Pattishall |
First Address | Chapel Hill, NC 27516-2539 |
Second Address | Chapel Hill, NC 27599-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8966204 | (05) | NC |
E07731 | (02) | NC |