Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 114 | NC |
N | 222Z00000X | Podiatrist | 114 | NC |
Y | 213EP1101X | Primary Podiatric Medicine | 114 | NC |
NPI | 1588667265 |
---|---|
Provider Name | Carroll D Kratzer |
First Address | Raleigh, NC 27612-5243 |
Second Address | Raleigh, NC 27612-5243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 02/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T64026 | (02) |