Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R10218 | IA |
N | 111NI0900X | Internist | R10218 | IA |
N | 207RC0000X | Internist - Cardiovascular Disease | R10218 | IA |
N | 207RG0100X | Gastroenterologist | R10218 | IA |
Y | 207RH0003X | Hematology & Oncology | 2021-01298 | NC |
N | 207RH0003X | Hematology & Oncology | R10218 | IA |
N | 207RP1001X | Pulmonary Disease | R10218 | IA |
NPI | 1053791517 |
---|---|
Provider Name | Josiah An |
First Address | Charlotte, NC 28275-1803 |
Second Address | Winston Salem, NC 27103-3013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2015 |
Last Update Date | 11/08/2021 |