Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 98-01341 | NC |
N | 2080P0214X | Pediatric Pulmonologist | 98-01341 | NC |
NPI | 1528121399 |
---|---|
Provider Name | Richard Kravitz |
First Address | Durham, NC 27710-0001 |
Second Address | Durham, NC 27710-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 05/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8911684 | (05) | NC |
E89759 | (02) |