Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | MD31747 | SC |
NPI | 1295963650 |
---|---|
Provider Name | Mary Colleen O'rourke |
First Address | Durham, NC 27705-3875 |
Second Address | Durham, NC 27705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 17/09/2019 |