Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 9400462 | NC |
N | 2080P0203X | Pediatric Critical Care Doctor | 9400462 | NC |
NPI | 1043290539 |
---|---|
Provider Name | Leon H Dejournett |
First Address | Charlotte, NC 28260-2373 |
Second Address | Asheville, NC 28803-1700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 15/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8928269 | (05) | NC |
F46144 | (02) |