Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 2021-01736 | NC |
N | 207PP0204X | Pediatric Emergency Physician | MD202407 | OR |
NPI | 1265962559 |
---|---|
Provider Name | Maura Olcese |
First Address | Raleigh, NC 27610-1231 |
Second Address | Raleigh, NC 27610-1231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2017 |
Last Update Date | 17/05/2021 |