Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 2018-01644 | NC |
NPI | 1003006172 |
---|---|
Provider Name | Nestor Quezada |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28209-3276 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 20/01/2021 |