Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 9763801-0501 | UT |
Y | 222Z00000X | Podiatrist | 9763801-0501 | UT |
N | 213ES0103X | Foot & Ankle Surgery | P84626 | NY |
NPI | 1033452263 |
---|---|
Provider Name | Charles Guy Hunter |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Sandy, UT 84094-5555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2013 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P84626 | NYS PERMIT (01) | NY |