Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 2011-01548 | NC |
NPI | 1033161203 |
---|---|
Provider Name | Richard Drimalla |
First Address | Charlotte, NC 28219-9305 |
Second Address | Gastonia, NC 28054-4985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 27/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B49098 | (02) | MI |
NC5680A | (02) | NC |
NC5680B | (02) | NC |
NC5680C | (02) | NC |
NC5680D | (02) | NC |
NC5680E | (02) | NC |
NC5680F | (02) | NC |
NC5680G | (02) | NC |
NC5680H | (02) | NC |
NC5680I | (02) | NC |
NC5680J | (02) | NC |
NC5680K | (02) | NC |
NC5680L | (02) | NC |
NC5680M | (02) | NC |
NC5680N | (02) | NC |
NC5680O | (02) | NC |