Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME41090 | FL |
Y | 2080P0201X | Pediatric Allergist | 2013-02199 | NC |
N | 2080P0201X | Pediatric Allergist | ME41090 | FL |
NPI | 1366453201 |
---|---|
Provider Name | John W Sleasman |
First Address | Charlotte, NC 28263-3362 |
Second Address | Durham, NC 27705-4699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 01/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
068571200 | (05) | FL |
68327 | BLUE CROSS BLUE SHIELD (01) | FL |
D21898 | (02) | FL |