Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 3353 | NC |
Y | 213ER0200X | Radiology | 3353 | NC |
NPI | 1982706313 |
---|---|
Provider Name | Richard Steven Pasko |
First Address | West End, NC 27376-0834 |
Second Address | Seven Lakes, NC 27376-0834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
085VN | BLUE CROSS BLUE SHIELD (01) | NC |