Provider Demographics
NPI:1619189057
Name:PACCA, RICHARD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:PACCA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:103 PROFESSIONAL PARK STE C
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-2581
Mailing Address - Country:US
Mailing Address - Phone:919-690-8853
Mailing Address - Fax:919-690-8866
Practice Address - Street 1:103 PROFESSIONAL PARK STE C
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2581
Practice Address - Country:US
Practice Address - Phone:919-690-8853
Practice Address - Fax:919-690-8866
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA230785207RC0000X, 207UN0901X
NC2010-00526207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2010-00526OtherNC LICENSE