Lookup NPI Numbers from the NPI Registry
NPI Profile for BRENT C DEATHERAGE in CHARLOTTE, NC.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1336373257 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 05/06/2009 | |
| Last updated | 08/10/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BRENT C DEATHERAGE
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BRENT C DEATHERAGE, PA-C