Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 2017-00901 | NC |
NPI | 1023596897 |
---|---|
Provider Name | Dr. Charles Teo |
First Address | Durham, NC 27710-0001 |
Second Address | Durham Nc, NC 27710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2018 |
Last Update Date | 02/08/2018 |