Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 2005-01357 | NC |
NPI | 1003884693 |
---|---|
Provider Name | Jonathan Paul Piccini SR. |
First Address | Durham, NC 27713-4430 |
Second Address | Durham, NC 27710-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 21/05/2012 |