Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 19 | NC |
NPI | 1144558941 |
---|---|
Provider Name | Dr. Charles Gordon Helms |
First Address | Charlotte, NC 28210-5443 |
Second Address | Charlotte, NC 28210-5443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2009 |
Last Update Date | 07/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40947 | BLUECROSS BLUE SHIELD OF NC PIN (01) | NC |