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Individual

JONATHAN PRIVETTE

Active
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Individual

JONATHAN PRIVETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
2008-01686
NC
207ZP0101X
Anatomic Pathology Physician
Primary
2008-01686
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
174UW
BCBS
NC
05
5922084
NC
Enumeration date
05/07/2007
Last updated
03/28/2013
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