Individual
DR. DIERDRE TANECIA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007-01897
NC
207R00000X
Internal Medicine Physician
Primary
82454
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14704
BCBS
NC
05
—
5908662
—
NC
05
—
NP0935
—
SC
01
—
P00448200
RR MEDICARE
NC
Enumeration date
03/29/2007
Last updated
10/26/2023
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