Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2014-00761 | NC |
NPI | 1003083148 |
---|---|
Provider Name | Dennis Michael Campbell |
First Address | Charlotte, NC 28260-0447 |
Second Address | Winston Salem, NC 27103-6973 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 21/03/2018 |