Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 32328 | NC |
NPI | 1023013893 |
---|---|
Provider Name | Courtenay Salisbury Whitman IV |
First Address | Elkin, NC 28621-2447 |
Second Address | Elkin, NC 28621-2447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 08/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7987137 | (05) | NC |
E56615 | (02) | NC |