Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 13720 | MD |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 9248 | NC |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DEN1000495 | DC |
NPI | 1083876189 |
---|---|
Provider Name | Shawana Neopi Patterson |
First Address | High Point, NC 27262-5017 |
Second Address | High Point, NC 27262-7293 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 10/04/2012 |