Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 17727 | NC |
NPI | 1013148063 |
---|---|
Provider Name | Alfred M Moncla |
First Address | Elizabeth City, NC 27909-3354 |
Second Address | Elizabeth City, NC 27909-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2009 |
Last Update Date | 06/08/2009 |