Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 200400417 | NC |
Y | 208600000X | Surgeon | 200400417 | NC |
NPI | 1013975721 |
---|---|
Provider Name | Dominic L Storto |
First Address | Fayetteville, NC 28303-5537 |
Second Address | Fayetteville, NC 28303-5537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 26/10/2017 |