Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 537 | SC |
NPI | 1154306181 |
---|---|
Provider Name | Dr. Brian G Ralph |
First Address | Charlotte, NC 28275-1649 |
Second Address | Charleston, SC 29414-5749 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 23/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00834839 | RAILROAD MEDICARE ID-RSFPN (01) | SC |
PD5373 | (05) | SC |