Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 432 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 432 | NC |
Y | 213ES0131X | Foot Surgery | 432 | NC |
NPI | 1346291325 |
---|---|
Provider Name | Bryan C Satterwhite |
First Address | Shallotte, NC 28470-4450 |
Second Address | Shallotte, NC 28470-4450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 26/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
890804V | (05) | NC |
U73945 | (02) | NC |