Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2010-01796 | NC |
Y | 207QS0010X | Family Doctor - Sports Medicine | 2010-01796 | NC |
NPI | 1063629392 |
---|---|
Provider Name | Chad Christopher Greer |
First Address | Charlotte, NC 28260-3949 |
Second Address | Raleigh, NC 27610-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 23/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063629392 | (05) | NC |