Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 20030857 | NC |
NPI | 1114956752 |
---|---|
Provider Name | Maeve E O'connor |
First Address | Charlotte, NC 28204-2534 |
Second Address | Charlotte, NC 28204-2534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 21/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01284 | BCBS (01) | NC |
8913444 | (05) | NC |
H14771 | (02) | |
NOO857 | (05) | SC |