Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 9801079 | NC |
NPI | 1215969613 |
---|---|
Provider Name | David Tait |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28207-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 05/01/2022 |