Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 2013-01628 | NC |
N | 207YS0123X | Facial Plastic Surgeon | 25MB08124100 | NJ |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 2013-01628 | NC |
NPI | 1831397363 |
---|---|
Provider Name | Dr. Brandon Ma |
First Address | Asheboro, NC 27203-5440 |
Second Address | Asheboro, NC 27203-5440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 07/08/2013 |