Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 011430 | GA |
NPI | 1841266111 |
---|---|
Provider Name | Carl M Nechtman |
First Address | Evans, GA 30809 |
Second Address | Evans, GA 30809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
306234 | BLUE CROSS (01) | GA |
4277485 | AETNA (01) | |
6629510 | CIGNA (01) | |
D30329 | (02) | |
P00177310 | MEDICARE RAILROAD (01) | GA |