Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 20125 | NC |
NPI | 1053304477 |
---|---|
Provider Name | Paul Brent Ferrell |
First Address | Shelby, NC 28150-3911 |
Second Address | Shelby, NC 28150-3911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 21/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8931712 | (05) | NC |
C87455 | (02) |