{"npi":"1972591055","type":"NPI-1","status":"active","name":{"display":"Paul Kostuchenko MD","other":[],"first":"PAUL","last":"KOSTUCHENKO","middle":"J","credential":"MD"},"specialty":{"primary_taxonomy":"207ND0900X","primary_taxonomy_description":"Dermatopathology Physician","slug":"dermatopathology-physician","schema_org_specialty":null,"all":[{"code":"207ND0900X","description":"Dermatopathology Physician","primary":true,"state":"NC","license":"200400056"}]},"addresses":[{"purpose":"LOCATION","street_1":"1345 WESTGATE CENTER DR STE B","city":"WINSTON SALEM","state":"NC","postal_code":"271033041","country_code":"US","phone":"3367681280","fax":"3367608443"},{"purpose":"MAILING","street_1":"1351-B WESTGATE CENTER DR","city":"WINSTON-SALEM","state":"NC","postal_code":"271033041","country_code":"US","phone":"3367681280","fax":"3367608444"}],"license":{"state":"NC","number":"200400056"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"Q0005F","state":"SC","issuer":null},{"type_code":"05","label":"Medicaid","value":"89136R2","state":"NC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20040728001652","type_code":"14-07","type_desc":"PRACTITIONER - DERMATOLOGY","state":"NC","pac_id":"9638149404"}]},"enumeration_date":"2005-10-12","last_updated":"2009-04-02","_meta":{"source":"NPPES","snapshot_date":"2009-04-02","doc_url":"https://findmynpi.com/api"}}