Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | NC | |
N | 111NI0900X | Internist | NC | |
Y | 207RH0003X | Hematology & Oncology | NC |
NPI | 1013180108 |
---|---|
Provider Name | Joellen C Speca |
First Address | Raleigh, NC 27607-7505 |
Second Address | Raleigh, NC 27607-7505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 09/04/2008 |