Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | NC | |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 038771 | CT |
NPI | 1013991090 |
---|---|
Provider Name | Maria J Small |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27710-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 26/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H18773 | (02) |