Individual
DR. JENNIFER MCDONALD WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1030 SIENA DRIVE, RALEIGH, NC 27587-2781
(919) 235-6511
(919) 341-3578
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9701657
NC
2080A0000X
Pediatric Adolescent Medicine Physician
9701657
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750352423
—
NC
05
—
891197N
—
NC
Enumeration date
01/30/2006
Last updated
10/31/2024
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