Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | 000585346 | NC |
Y | 208000000X | Pediatrician | 22678 | NC |
NPI | 1922097740 |
---|---|
Provider Name | Ellen Boyd |
First Address | Asheville, NC 28813-0268 |
Second Address | Asheville, NC 28803-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 15/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8917248 | (05) | NC |
F62533 | (02) |