Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 15610 | NC |
NPI | 1013937440 |
---|---|
Provider Name | Barry M. Welborne |
First Address | Charlotte, NC 28260-1643 |
Second Address | Charlotte, NC 28203-5866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 02/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013937440 | (05) | NC |
86429 | BCBS (01) | NC |
8986429 | (05) | NC |
C87084 | (02) | NC |
N15610 | (05) | SC |