Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 15495 | SC |
NPI | 1003844994 |
---|---|
Provider Name | Patricia Tonkowicz |
First Address | Charlotte, NC 28219-9305 |
Second Address | Fort Mill, SC 29715-8906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 27/09/2021 |