Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 200200337 | NC |
NPI | 1073557633 |
---|---|
Provider Name | Joseph Anthony Coladonato |
First Address | Greensboro, NC 27405-3654 |
Second Address | Greensboro, NC 27405-3654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 09/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1313J | BLUE CROSS BLUE SHIELD ID (01) | NC |
3100062 | UHC PROVIDER ID (01) | NC |
390008337 | RRM PROVIDER ID (01) | NC |
800314 | PARTNER'S PROVIDER ID (01) | NC |
891313J | (05) | NC |
G66502 | (02) | NC |