Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2008 01744 | NC |
N | 2086S0122X | Plastic and Reconstructive Surgery | 2008-01744 | NC |
NPI | 1174604706 |
---|---|
Provider Name | Andrew John Leishman Gear |
First Address | Charlotte, NC 28270-0254 |
Second Address | Miramar, FL 33027-6308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 02/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
876402600 | (05) | MN |