Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD049479L | PA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA09809000 | NJ |
NPI | 1821077355 |
---|---|
Provider Name | Robert W Pattillo |
First Address | Cape May Court House, NJ 08210-2264 |
Second Address | Cape May Court House, NJ 08210-2264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1473916 | (05) | PA |
F28297 | (02) |