Provider Demographics
NPI:1518954767
Name:PATRONE, NICHOLAS ANGELO (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANGELO
Last Name:PATRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 GREEN ST E
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4105
Mailing Address - Country:US
Mailing Address - Phone:252-293-0013
Mailing Address - Fax:252-243-2576
Practice Address - Street 1:303 GREEN ST E
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4105
Practice Address - Country:US
Practice Address - Phone:252-243-9800
Practice Address - Fax:252-243-9888
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22161207RR0500X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8966201Medicaid
NC110095571OtherRAILROAD MEDICARE
NC8966201Medicaid
NC29119OtherMEDCOST
NC66201OtherBCBSNC
NC29119OtherMEDCOST
NCC85917Medicare UPIN