Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 2013-00841 | NC |
NPI | 1265635940 |
---|---|
Provider Name | Conor Regan |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2007 |
Last Update Date | 31/03/2021 |