Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101235869 | VA |
NPI | 1598770372 |
---|---|
Provider Name | Carl Raphael St. Remy |
First Address | Atlanta, GA 30374-1593 |
Second Address | Norfolk, VA 23502-4700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 08/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007573642 | MEDICARE (01) | VA |
010060842 | (05) | VA |
010060842 | VA PREMIER (01) | VA |
09-01530 | UHC (01) | VA |
104676 | ANTHEM BCBS (01) | VA |
1598770372 | TRICARE (01) | VA |
4122371004 | CIGNA (01) | VA |
65775 | OPTIMA/SENTARA HEALTH (01) | VA |
669649 | NC PPO (01) | NC |
7338381 | AETNA (01) | VA |
790661P | NC MEDICAID (01) | NC |
790661P | NORTH CAROLINA MEDICAID (01) | VA |