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
Fax: (704) 316-5075
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598741563 NPPES
North Carolina MEDICAID 218605
North Carolina MEDICAID 5900708

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