Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 34199 | TN |
N | 208600000X | Surgeon | 34199 | TN |
N | 2086S0102X | Surgical Critical Care | 34199 | TN |
Y | 2086S0102X | Surgical Critical Care | 49018 | WA |
NPI | 1114991668 |
---|---|
Provider Name | Christopher Carr |
First Address | Bremerton, WA 98310-4229 |
Second Address | Bremerton, WA 98310-4229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 18/08/2011 |