Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 36570 | NC |
Y | 2080P0214X | Pediatric Pulmonologist | 36570 | NC |
NPI | 1366403818 |
---|---|
Provider Name | John Clarke Mcintosh |
First Address | Asheville, NC 28803-8597 |
Second Address | Asheville, NC 28803-8597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 09/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C76775 | (02) |