Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2017-01540 | NC |
NPI | 1225397516 |
---|---|
Provider Name | Shaylar Padgett |
First Address | Indianapolis, IN 46202-4617 |
Second Address | High Point, NC 27262-4317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2012 |
Last Update Date | 26/08/2021 |