Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 31034 | NC |
NPI | 1326154824 |
---|---|
Provider Name | Dr. Charles Thomas Humphries |
First Address | Charlotte, NC 28277-8915 |
Second Address | Charlotte, NC 28277-8745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8944546 | (05) | NC |
C86879 | (02) | NC |