Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25128 | NC |
Y | 208600000X | Surgeon | 25128 | NC |
N | 2082S0105X | Plastic Hand Surgeon | 25128 | NC |
NPI | 1073598017 |
---|---|
Provider Name | Anthony John Defranzo JR. |
First Address | Winston Salem, NC 27103-6074 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22903 | MEDCOST (01) | |
28274 | BCBS OF NC (01) | |
2956 | PARTNERS (01) | |
8928274 | (05) | NC |
C83497 | (02) |