Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 0101230568 | VA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 18180 | SC |
NPI | 1295795854 |
---|---|
Provider Name | Barbara Head |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-4933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 21/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006216463 | (05) | VA |
G57066 | (02) | VA |