Pena, Jose Raul
Pena, Jose Raul is an individual health care provider with primary practice located at 9604 Holly Point Dr , Huntersville NC 28078-4913. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Pena, Jose Raul can be contacted via phone (704) 316-5070.Contact Information
Primary practice address
9604 Holly Point Dr
Huntersville NC 28078-4913
Phone: (704) 316-5070
Fax: (704) 316-5075
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 009000253 | North Carolina |
Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | 009000253 | North Carolina |
Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 26801 | North Carolina |
Profile Details
NPI number | 1598741563 |
---|---|
LBN Legal business name | Pena, Jose Raul |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 21st, 2005 |
Last updated | Oct 25th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1598741563 | NPPES |
North Carolina | MEDICAID | 218605 | |
North Carolina | MEDICAID | 5900708 |
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