Individual
TIZIANA PANIAGUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1085 NORTHEAST GATEWAY COURT NE, SUITE 200, CONCORD, NC 28025-2412
(704) 403-8650
(704) 403-8655
Mailing address
1085 NORTHEAST GATEWAY COURT NE, SUITE 200, CONCORD, NC 28025-2412
(704) 403-8650
(704) 403-8655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2008-00442
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232009
MEDICARE, ENTITY PTAN
NC
05
—
5910501
—
NC
Enumeration date
08/21/2008
Last updated
02/07/2014
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