Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT210747 | PA |
N | 208600000X | Surgeon | MT210747 | PA |
Y | 2086S0102X | Surgical Critical Care | RTL21-0942 | NC |
NPI | 1013363043 |
---|---|
Provider Name | Matelin Paul Crosen |
First Address | Chapel Hill, NC 27599-0001 |
Second Address | Chapel Hill, NC 27599-6202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2016 |
Last Update Date | 06/07/2021 |