Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 2008-01394 | NC |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 2008-01394 | NC |
NPI | 1306030739 |
---|---|
Provider Name | Dr. Brian Allen Krenzel |
First Address | Charlotte, NC 28209-3239 |
Second Address | Hickory, NC 28602-1363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 13/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
177100V | (02) | |
2008-01394 | LICENSE (01) | NC |