Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2007-01170 | NC |
NPI | 1043395171 |
---|---|
Provider Name | Gurvinder K Deogun |
First Address | Charlotte, NC 28260-3725 |
Second Address | Raleigh, NC 27614-6628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2021941B | MEDICARE PTAN (01) | NC |
5908675 | (05) | NC |
7202876 | AETNA (01) | NC |
P00643305 | RAILROAD MEDICARE (01) | NC |