Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 2017-00456 | NC |
Y | 207YP0228X | Pediatric Otolaryngology | 2017-00456 | NC |
NPI | 1427360627 |
---|---|
Provider Name | Eleanor Pitz Kiell |
First Address | Charlotte, NC 28260-2658 |
Second Address | Winston Salem, NC 27157-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 01/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MT207868 | PA LICENSE # (01) | PA |