Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2004-00563 | NC |
NPI | 1023058245 |
---|---|
Provider Name | Douglas A Nigbor |
First Address | Charlotte, NC 28204-3106 |
Second Address | Gastonia, NC 28054-3450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 04/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89-1366F | (05) | NC |
I08224 | (02) | NC |
N00564 | (05) | SC |